When you begin an antenatal visit, one of the first things you should ask the pregnant woman is if she has any symptoms that suggest poor nutrition or lack of iodine in her diet. This is very important, because poor maternal nutrition is associated with poor pregnancy outcomes like a small baby, and the child may be short in stature. The questions you ask her should aim to find out if she has any of the following warning symptoms (i.e. things she notices herself):

Warning symptoms

Not wanting to eat
Not gaining weight
Weakness and general ill-health
Sores, rashes, or other skin problems
Sore or bleeding gums
Stomach problems or diarrhoea
Burning or numbness of the feet.

The effects of iodine deficiency are:

A woman with goitre

Figure 9.1 Goitre may be a warning sign of lack of iodine in the diet.

Goitre (swelling in the front of the neck caused by iodine deficiency; Figure 9.1)
Short children
Children with deafness

Children with cretinism, a disability that affects thinking.

If you suspect that a pregnant woman's health is poor due to inadequate nutrition, or lack of iodine in her diet, advise her about good nutrition and iodine supplementation. You will learn how to do this in Study Session 14 of this Module.