TY - JOUR
T1 - First-trimester exposure to gadolinium-based contrast agents
T2 - A utilization study of 4.6 Million U.S. Pregnancies
AU - Bird, Steven T.
AU - Gelperin, Kate
AU - Sahin, Leyla
AU - Bleich, Karen B.
AU - Fazio-Eynullayeva, Elnara
AU - Woods, Corinne
AU - Radden, Erica
AU - Greene, Patty
AU - McCloskey, Carolyn
AU - Johnson, Tamara
AU - Shinde, Mayura
AU - Krefting, Ira
N1 - Funding Information:
Supported by the Food and Drug Administration (HHSF223201400030I).
Publisher Copyright:
© RSNA, 2019.
PY - 2019
Y1 - 2019
N2 - Background: The safety of gadolinium-based contrast agent (GBCA) exposure during pregnancy has not been established, and the use of GBCAs during pregnancy is not recommended unless it is essential to the health of the woman or fetus. Purpose: To examine the prevalence of GBCA exposure in a large sample of pregnancies resulting in a live birth. Materials and Methods: The Sentinel Distributed Database was used to retrospectively identify U.S. pregnancies that resulted in live births between 2006 and 2017 from 16 data partners. The main outcome was the prevalence of MRI procedures with and without GBCAs, sorted by anatomic location and trimester, among pregnant and matched comparator women. Results: Among 4 692 744 pregnancies resulting in a live birth, we identified 6879 exposures to GBCAs in 5457 pregnancies, representing one contrast-enhanced MRI examination per 860 pregnancies (0.12% of all pregnancies). Most contrast-enhanced MRI examinations were performed in the head (n = 3499), although pelvic and abdominal MRI constituted 22.3% (n = 1536) of all contrast-enhanced MRI examinations during pregnancy. The majority (70.2%) of GBCA exposures occurred during the first trimester, with a 4.3-fold greater prevalence compared with that in the second trimester and a 5.1-fold greater prevalence compared with that in the third trimester. Conclusion: This study identified higher rates of gadolinium-based contrast agent (GBCA) exposure during the first few weeks of pregnancy compared with the later weeks of pregnancy, suggesting inadvertent exposure to GBCAs might occur before pregnancy is recognized.
AB - Background: The safety of gadolinium-based contrast agent (GBCA) exposure during pregnancy has not been established, and the use of GBCAs during pregnancy is not recommended unless it is essential to the health of the woman or fetus. Purpose: To examine the prevalence of GBCA exposure in a large sample of pregnancies resulting in a live birth. Materials and Methods: The Sentinel Distributed Database was used to retrospectively identify U.S. pregnancies that resulted in live births between 2006 and 2017 from 16 data partners. The main outcome was the prevalence of MRI procedures with and without GBCAs, sorted by anatomic location and trimester, among pregnant and matched comparator women. Results: Among 4 692 744 pregnancies resulting in a live birth, we identified 6879 exposures to GBCAs in 5457 pregnancies, representing one contrast-enhanced MRI examination per 860 pregnancies (0.12% of all pregnancies). Most contrast-enhanced MRI examinations were performed in the head (n = 3499), although pelvic and abdominal MRI constituted 22.3% (n = 1536) of all contrast-enhanced MRI examinations during pregnancy. The majority (70.2%) of GBCA exposures occurred during the first trimester, with a 4.3-fold greater prevalence compared with that in the second trimester and a 5.1-fold greater prevalence compared with that in the third trimester. Conclusion: This study identified higher rates of gadolinium-based contrast agent (GBCA) exposure during the first few weeks of pregnancy compared with the later weeks of pregnancy, suggesting inadvertent exposure to GBCAs might occur before pregnancy is recognized.
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U2 - 10.1148/radiol.2019190563
DO - 10.1148/radiol.2019190563
M3 - Article
C2 - 31429682
AN - SCOPUS:85072509160
SN - 0033-8419
VL - 293
SP - 193
EP - 200
JO - RADIOLOGY
JF - RADIOLOGY
IS - 1
ER -