748: Pre-conception exposure to gadolinium: An analysis of maternal & neonatal outcomes

Abstract

It is increasingly recognized that many metals, including Gadolinium (Gd), can be incorporated into human bone. The calcium requirements of pregnancy favor a state of bone resorption, during which metals, such as lead, are released into the maternal circulation. This study aims to determine if pre-conception exposure to Gd-contrast agents is associated with adverse pregnancy or neonatal events. This was a retrospective chart review identifying women ages 18-55 with an obstetric admission resulting in a live born singleton between 2007-2016. Women having an MRI within 10 years of their estimated date of conception were included in the study. Cohorts were defined by MRI type: Non-Gd-MRI vs. Gd-Contrast MRI (Gd-MRI). Two time points were examined: MRI within 10 years of conception and MRI within 2 years of conception. Pregnancy outcomes included gestational diabetes, chorioamnionitis and a composite outcome of placental morbidity (pre-eclampsia, abruption, IUGR). Neonatal outcomes included gestational age, birth weight and a composite outcome of newborn morbidity (NICU admission, APGAR <7 at 5 minutes, surfactant administration, need for respiratory support and neonatal death). Analysis by Chi-square, Fisher’s exact, T-tests and T-test with bootstrapping. Logistic regression and generalized linear models were used to control for confounding. The average interval between MRI and conception was slightly shorter in the Gd-MRI cohort at 2 years, but not at 10 years. Differences in other baseline characteristics are listed in Table 1. Exposure to Gd-MRI within 10 years of conception was associated with decreased odds of having a newborn with a low 5 minute APGAR (Table 2). No other significant differences were found between Non-Gd MRI and Gd-MRI exposed subjects when MRIs were within 2 years of conceptions, or within 10 years of conception. Pre-conception exposure to gadolinium was not associated with obvious adverse maternal or neonatal outcomes during pregnancy or in the immediate newborn period.View Large Image Figure ViewerDownload Hi-res image Download (PPT)