PERKEMBANGAN FETUS DALAM KONDISI DEFISIENSI YODIUM DAN CUKUP YODIUM
Iodine is a trace element present in the human body, and it is essential substrate for the synthesis of the thyroid hormone. Iodine deficiency during pregnancy may results the increase risk of spontaneous abortion, premature birth and early infant death, as well as transient neonatal hyperthyrotropinemia. This deficiency also has a deleterious effect on the development of the infant’s tone, since may cause hypotonia both in the extremities and axial muscles during early life. The deleterious effect is also found for the postural responses (late infant reflexes) but not for the neonatal (so-called primitive) reflexes. This developmental delay does not persist during the course of infancy since catch up can be attained by the age of 6 months. Iodine deficiency during pregnancy also has a deleterious effect on the domains of fine motor function, adaptation, personal-social, communication and gross motor development of children from 0 to 24 months of age. These delays are correlated to the newborn’s neurological integrity. Since these delays are generally observed in the same children, this suggests that these children should be considered at high risk in terms of later problems of mental retardation and mental deficiency. Development of the cortical brain areas is the most vulnerable to iodine deficiency during pregnancy. The timing of insults is within the second and third trimester of pregnancy. Insults early in the second trimester are critical. Pregnant women are an important target group in iodine deficiency disorders (IDD) control programs and should be included in surveillance programs. Clinical and laboratory examination including TSH screening in this population should be performed, given its correlation with children’s subsequent neurodevelopment.
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