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The increase in kidney clearance during pregnancy causes more iodide to be excreted and causes relative iodine deficiency and as a result an increase in thyroid size. Estrogen-stimulated increase in thyroid-binding globulin (TBG) leads to an increase in total thyroxine (T4), but free thyroxine (T4) and triiodothyronine (T3) remain normal. [5]
Preventive healthcare strategies are described as taking place at the primal, [2] primary, [13] secondary, and tertiary prevention levels. Although advocated as preventive medicine in the early twentieth century by Sara Josephine Baker, [14] in the 1940s, Hugh R. Leavell and E. Gurney Clark coined the term primary prevention.
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