Endocrine Abstracts

Iodine surveys in pregnant women in UK and Ireland have consistently demonstrated iodine deficiency since the 1990s (nine cohorts) but there remains no fortification program. In its absence education and supplementation are key. Knowledge scores have been low across the UK. However, since the last report from NI 10 years ago, the NI antenatal “Pregnancy Book” provided at booking has a new iodine entry. Recently the British Dietetic Association (BDA) have published a two-page Iodine Fact Sheet; however, it is cautionary rather than encouraging regarding supplementation in pregnancy. We explored the knowledge of a cohort-subset of 118 pregnant women from NI recruited to a randomised controlled intervention: milk provision plus BDA factsheet vs BDA factsheet provision alone. An iodine knowledge questionnaire was completed before and after intervention. Separately, semi-structured interviews were conducted in six pregnant women and 10 midwives (including two lecturers) from across the UK. Of the 118 cohort, 71% reported taking an iodine-containing supplement. At baseline 84 women completed the questionnaire and 39% confirmed that they were aware that iodine requirements increased in pregnancy. Only 21% recognised milk as a good source of iodine. At study end, of 46 participants, 67% were aware of increased requirements but there was no improvement in recognition of dietary iodine sources. Midwives reported poor iodine knowledge with nutrition education a low priority during training. Their focus during antenatal care was on relevant food avoidance and multivitamin use. Interviewed women had low iodine knowledge and lacked confidence in their ability to achieve their iodine requirements. In the UK, midwives are reported as the primary source of dietary advice during pregnancy and so need to be a focus. Educational strategies may include changes in midwifery curriculum, pregnancy-specific fact sheets, social media campaigns and clearer messaging around supplementation.