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First-Trimester MRI Appears to Be Safe, Gadolinium-Enhanced MRI Still Risky

By Amy Orciari Herman

Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM

First-trimester MRI does not lead to adverse fetal or childhood outcomes, according to a retrospective study in JAMA. In contrast, gadolinium-enhanced MRI in any trimester appears to be risky, thus reinforcing guidelines advising against its use.

Using healthcare databases from Ontario, Canada, researchers studied over 1.4 million deliveries that occurred between 2003 and 2015. Some 1700 of these pregnancies were exposed to MRI in the first trimester, and 400 were exposed to gadolinium-enhanced MRI at any time.

Compared with unexposed pregnancies, those with first-trimester MRI showed no increase in risk for five outcomes assessed from birth through age 4 years. These outcomes included stillbirth or neonatal death; congenital anomaly; neoplasm; vision loss; and hearing loss.

However, gadolinium MRI was associated with a 36% increased risk for any rheumatological, inflammatory, or infiltrative skin condition through age 4, and also with nearly a fourfold increase in risk for stillbirth or neonatal death (although there were just 7 such events).

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