University of Florida Reports Findings in Managed Care (Risk of fetal/neonatal death or neonatal intensive care unit admission associated with gadolinium magnetic resonance imaging exposure during pregnancy): Managed Care

2022 NOV 01 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- New research on Managed Care is the subject of a report. According to news reporting originating in Gainesville, Florida, by NewsRx journalists, research stated, “Concerns about prenatal exposure to magnetic resonance imaging with gadolinium-based contrast agents have been raised due to nonclinical findings of gadolinium retention in fetal tissue and one population-based study suggesting an association with adverse pregnancy outcomes. To evaluate the association between prenatal magnetic resonance imaging exposure with and without gadolinium-based contrast agents and fetal/neonatal death and neonatal intensive care unit admission.”

The news reporters obtained a quote from the research from the University of Florida, “We constructed a retrospective cohort of >11 million Medicaid-covered pregnancies between 1999-2014 to evaluate the association between prenatal magnetic resonance imaging exposure with and without gadolinium-based contrast agents and fetal/neonatal death (primary endpoint) and neonatal intensive care unit admission (secondary endpoint). Medicaid claims data were linked to medical records, Florida birth and fetal death records, and the National Death Index to validate outcomes and gestational age estimates. Pregnancies with multiples, concurrent cancer, teratogenic drug exposure, magnetic resonance imaging focused on fetal/pelvic evaluation, with undetermined gadolinium-based contrast agent use, or preceded by or contemporaneous with congenital anomaly diagnoses were excluded. We adjusted for potential confounders with standardized mortality ratio weighting using propensity scores. Among 5,991 qualifying pregnancies we found 11 fetal/neonatal deaths in the gadolinium- based contrast agent magnetic resonance 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% CI 0.34-1.55); the neonatal intensive care unit admission adjusted relative risk was 1.03 (0.76-1.39). Sensitivity analyses varying timing of magnetic resonance imaging or repeat magnetic resonance imaging during pregnancy and simulating the impact of exposure misclassification corroborated these results. This study addresses safety concerns related to prenatal exposure to gadolinium-based contrast agent magnetic resonance imaging and risk of fetal/neonatal death or need for neonatal intensive care unit admission.”

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

This research has been peer-reviewed.

For more information on this research see: Risk of fetal/neonatal death or neonatal intensive care unit admission associated with gadolinium magnetic resonance imaging exposure during pregnancy. American Journal of Obstetrics and Gynecology, 2022. 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/)

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

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.

The publisher of the American Journal of Obstetrics and Gynecology can be contacted at: Mosby-elsevier, 360 Park Avenue South, New York, NY 10010-1710, USA.

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