Maternal Iodine Exposure: A Case of Fetal Goiter and Neonatal Hearing Loss.

MedStar author(s):
Citation: Pediatrics. 137(4), 2016 AprPMID: 27006474Institution: MedStar Washington Hospital CenterDepartment: Obstetrics and Gynecology, Maternal-Fetal MedicineForm of publication: Journal ArticleMedline article type(s): Case Reports | Journal ArticleSubject headings: *Fetal Diseases/ci [Chemically Induced] | *Goiter/ci [Chemically Induced] | *Hearing Loss/ci [Chemically Induced] | *Hypothyroidism/dt [Drug Therapy] | *Iodine/ae [Adverse Effects] | *Pregnancy Complications/dt [Drug Therapy] | Adult | Female | Fetal Diseases/dg [Diagnostic Imaging] | Humans | Infant, Newborn | Iodine/tu [Therapeutic Use] | Magnetic Resonance Imaging | Male | Maternal Exposure | Pregnancy | Prenatal Diagnosis | Thyroid Gland/dg [Diagnostic Imaging] | Thyroid Gland/em [Embryology] | Thyrotropin/bl [Blood] | UltrasonographyYear: 2016Local holdings: Available online from the MWHC library: 1948 - present, Available in print through MWHC library: 1999 - 2006ISSN:
  • 0031-4005
Name of journal: PediatricsAbstract: A 27-year-old gravid 1 at 27 weeks 6 days with a history of hypothyroidism had an ultrasound that demonstrated a 3.9 x 3.2 x 3.3-cm well-circumscribed anterior neck mass, an extended fetal head, and polyhydramnios. Further characterization by magnetic resonance imaging (MRI) showed a fetal goiter. During her evaluation for the underlying cause of the fetal goiter, the patient revealed she was taking nutritional iodine supplements for treatment of her hypothyroidism. She was ingesting 62.5 times the recommended amount of daily iodine in pregnancy. The excessive iodine consumption caused suppression of the fetal thyroid hormone production, resulting in hypothyroidism and goiter formation. After the iodine supplement was discontinued, the fetal goiter decreased in size. At delivery, the airway was not compromised. The infant was found to have reversible hypothyroidism and bilateral hearing loss postnatally. This case illustrates the importance of examining for iatrogenic causes for fetal anomalies, especially in unregulated nutritional supplements. Copyright © 2016 by the American Academy of Pediatrics.All authors: Hull AD, Marc-Aurele KL, Overcash RT, Ramos GAFiscal year: FY2016Digital Object Identifier: Date added to catalog: 2017-07-07
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 27006474 Available 27006474

Available online from the MWHC library: 1948 - present, Available in print through MWHC library: 1999 - 2006

A 27-year-old gravid 1 at 27 weeks 6 days with a history of hypothyroidism had an ultrasound that demonstrated a 3.9 x 3.2 x 3.3-cm well-circumscribed anterior neck mass, an extended fetal head, and polyhydramnios. Further characterization by magnetic resonance imaging (MRI) showed a fetal goiter. During her evaluation for the underlying cause of the fetal goiter, the patient revealed she was taking nutritional iodine supplements for treatment of her hypothyroidism. She was ingesting 62.5 times the recommended amount of daily iodine in pregnancy. The excessive iodine consumption caused suppression of the fetal thyroid hormone production, resulting in hypothyroidism and goiter formation. After the iodine supplement was discontinued, the fetal goiter decreased in size. At delivery, the airway was not compromised. The infant was found to have reversible hypothyroidism and bilateral hearing loss postnatally. This case illustrates the importance of examining for iatrogenic causes for fetal anomalies, especially in unregulated nutritional supplements.

Copyright © 2016 by the American Academy of Pediatrics.

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