Public Health Nutrition: 12(6), 849–852 doi:10.1017/S1368980008003315 Iodine deficiency in pregnant women in eastern Turkey (Malatya Province): 7 years after the introduction of mandatory table salt iodization Mucahit Egri 1, *, Cihan Ercan 2 and Leyla Karaoglu 3 1 Gaziosmanpasa University, School of Medicine, Department of Public Health, Tokat 60100, Turkey: 2 Goynuk State Hospital, Bolu, Turkey: 3 Inonu University, School of Medicine, Department of Public Health, Malatya, Turkey Submitted 26 July 2007: Accepted 19 May 2008: First published online 29 July 2008 Abstract Objective: The aim of the present study was to evaluate the urinary I excretion of pregnant women in Malatya Province, eastern Turkey. Design and setting: A cross-sectional study was performed on pregnant women in urban and rural settlements of Malatya Province. Subjects: Urinary I excretion was measured for 824 pregnant women who were randomly selected using a probability-proportional-to-size sampling methodology. Results: Median urinary I concentration (UIC) of pregnant women was 77?4 mg/l. The percentage of pregnant women with UIC below 100 mg/l was 83?3. Conclusion: These results indicate that I deficiency disorders (IDD) is still a problem in Malatya Province and most certainly in other parts of the country. Proper monitoring of I content of the salt sold or used in the area, in order to strengthen the IDD intervention programme, is suggested. Keywords Urinary iodine Iodine deficiency Pregnant women Turkey I deficiency and related disorders are still important public health concerns affecting more than 130 countries and 2?2 billion people (1) . Children born in I-deficient areas are at risk of neurological disorders and mental retardation because of the combined effects of maternal, fetal and neonatal hypothyroxinaemia (2) . Thyroid hormones act by regulating the metabolic pattern of most cells of the organism and I is required for their synthesis. They also play a determining part in the process of early growth and development of most organs, especially of the brain, which occurs in man during fetal and early postnatal life. Thus, I deficiency, if severe enough to affect thyroid hormone synthesis during this critical period, will result in brain damage during fetal development as a result of maternal hypothyroidism (3,4) . I-deficient communities have been found to score 10–15 points lower in intelligence quotient tests than people in I-replete areas (1) . I deficiency disorders (IDD) can be prevented by ensuring adequate I intake, and this is the primary objective of the current worldwide drive to eliminate IDD (5) . According to the dietary allowances for I, as endorsed by the International Council for Control of Iodine Deficiency Disorders (ICCIDD) and WHO, the ideal I intake should be 150 mg/d for normal adults and 200 mg/d for pregnant and lactating women (6,7) . Turkey is known as an area with mild to moderate I deficiency according to previous epidemiological studies (8,9) . Total goitre prevalence found in Turkey was as high as 30?5 %, and that of visible goitre 6?7 %, in a survey com- pleted in 1987 (10) . In a survey conducted in 1997 in twenty cities of Turkey by measuring sonographic thyroid volumes and urinary iodine concentrations (UIC), goitre prevalence was found to be 31?8 % (between 5 % and 56 %) and UIC was found to be less than 100 mg/l in all cities. In a more recent survey among schoolchildren in Malatya Province, median UIC was 78 mg/l, indicating mild I deficiency (11) . Iodization of table salt is the most effective way to correct I deficiency (12) . In Turkey, iodization of table salt was initi- ated in 1968 on a voluntary basis and then legal regulation was made targeting mandatory table salt iodization in 1998. Since 1998, all table salt has to be iodized legally; however, iodization of salt for the food industry is not enforced (13) . Evaluation of the effects of mandatory table salt iodization has not been performed in Malatya Province since 1998. Assessing UIC is one of the recommended methods to evaluate the status of I nutrition of the population. In the present study, by measuring UIC, we aimed to evaluate I nutrition status in pregnant women living in Malatya, which was defined as a mildly endemic goitrous area before the beginning of the mandatory salt iodization programme. Material and methods Subjects The studied population comprised pregnant women who were residents of Malatya Province. Malatya is a province *Corresponding author: Email megri@gop.edu.tr r The Authors 2008