Data on Managed Care Reported by Researchers at University of Florida (Risk of Fetal or Neonatal Death or Neonatal Intensive Care Unit Admission Associated With Gadolinium Magnetic Resonance Imaging Exposure During Pregnancy): Managed Care

2023 AUG 24 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Data detailed on Managed Care have been presented. According to news originating from Gainesville, Florida, by NewsRx correspondents, research stated, “Concerns have been raised about prenatal exposure to magnetic resonance imaging with gadolinium-based contrast agents because of nonclinical findings of gadolinium retention in fetal tissue and 1 population-based study reporting an association with adverse pregnancy outcomes. This study aimed to evaluate the association between prenatal magnetic resonance imaging exposure with and without gadolinium-based contrast agents and fetal and neonatal death and neonatal intensive care unit admission.”

Our news journalists obtained a quote from the research from the University of Florida, “We constructed a retrospective cohort of >11 million Medicaid-covered pregnancies between 1999 and 2014 to evaluate the association between prenatal magnetic resonance imaging exposure with and without gadolinium-based contrast agents and fetal and neonatal death (primary endpoint) and neonatal intensive care unit admissions (secondary endpoint). Medicaid claims data were linked to medical re-cords, Florida birth and fetal death records, and the National Death Index to validate the outcomes and gestational age estimates. Pregnancies with multiples, concurrent cancer, teratogenic drug exposure, magnetic resonance imaging focused on fetal or pelvic evaluation, undetermined gadolinium-based contrast agent use, or those preceded by or contem-poraneous with congenital anomaly diagnoses were excluded. We adjusted for potential confounders with standardized mortality ratio weighting using propensity scores. Among 5991 qualifying pregnancies, we found 11 fetal or neonatal deaths in the gadolinium-based contrast agent magnetic reso-nance imaging group (1.4%) and 73 in the non-gadolinium-based contrast agent magnetic resonance imaging group (1.4%) with an adjusted relative risk of 0.73 (95% confidence interval, 0.34-1.55); the neonatal intensive care unit admission adjusted relative risk was 1.03 (0.76-1.39). Sensitivity analyses investigating the timing of magnetic resonance imaging or repeat magnetic resonance imaging exposure during pregnancy and simulating the impact of exposure misclassification corroborated these results. This study addressed the safety concerns related to prenatal exposure to gadolinium-based contrast agents used in magnetic resonance imaging and the risk thereof on fetal and neonatal death or the need for neonatal intensive care unit admission.”

According to the news editors, the research concluded: “Although the results on fatal or severe acute effects are reassuring, the impact on subacute outcomes was not evaluated.”

This research has been peer-reviewed.

For more information on this research see: Risk of Fetal or Neonatal Death or Neonatal Intensive Care Unit Admission Associated With Gadolinium Magnetic Resonance Imaging Exposure During Pregnancy. American Journal of Obstetrics and Gynecology, 2023;228(4). American Journal of Obstetrics and Gynecology can be contacted at: Mosby-elsevier, 360 Park Avenue South, New York, NY 10010-1710, USA. (Elsevier - www.elsevier.com; American Journal of Obstetrics and Gynecology - http://www.journals.elsevier.com/american-journal-of-obstetrics-and-gynecology/)

The news correspondents report that additional information may be obtained from Almut G. Winterstein, University of Florida, Dept. of Pharmaceutical Outcomes and Policy, College of Pharmacy, Gainesville, FL 32611, United States. Additional authors for this research include Thuy N. Thai, Sabina Nduaguba, Nicole E. Smolinski, Xi Wang, Sonja A. Rasmussen, Leyla Sahin, Ira Krefting, Kate Gelperin and Steven T. Bird.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1016/j.ajog.2022.10.005. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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