MRI assessed placental volume and adverse pregnancy outcomes: Secondary analysis of prospective cohort study.

Autor: Gibbins KJ; Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, Oregon, USA. Electronic address: gibbins@ohsu.edu., Roberts VHJ; Oregon National Primate Research Center, Oregon Health & Science University, Portland, Oregon, USA., Lo JO; Department of Obstetrics & Gynecology, Oregon Health & Science University, Oregon National Primate Research Center, Portland, Oregon, USA., Boniface ER; Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, Oregon, USA., Schabel MC; Advanced Imaging Resource Center, Oregon Health & Science University, Portland, Oregon, USA., Silver RM; Department of Obstetrics & Gynecology, University of Utah Health, Salt Lake City, Utah, USA., Frias AE; Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, Oregon, USA.
Jazyk: angličtina
Zdroj: Placenta [Placenta] 2024 Sep 02; Vol. 154, pp. 168-175. Date of Electronic Publication: 2024 Jul 14.
DOI: 10.1016/j.placenta.2024.07.007
Abstrakt: Introduction: Our goal was to evaluate the potential utility of magnetic resonance imaging (MRI) placental volume as an assessment of placental insufficiency.
Methods: Secondary analysis of a prospective cohort undergoing serial placental MRIs at two academic tertiary care centers. The population included 316 participants undergoing MRI up to three times throughout gestation. MRI was used to calculate placental volume in milliliters (ml). Placental-mediated adverse pregnancy outcome (cAPO) included preeclampsia with severe features, abnormal antenatal surveillance, and perinatal mortality. Serial measurements were grouped as time point 1 (TP1) <22 weeks, TP2 22 0/7-29 6/7 weeks, and TP3 ≥30 weeks. Mixed effects models compared change in placental volume across gestation between cAPO groups. Association between cAPO and placental volume was determined using logistic regression at each TP with discrimination evaluated using area under receiver operator curve (AUC). Placental volume was then added to known clinical predictive variables and evaluated with test characteristics and calibration.
Results: 59 (18.7 %) of 316 participants developed cAPO. Placental volume growth across gestation was slower in the cAPO group (p < 0.001). Placental volume was lower in the cAPO group at all time points, and alone was moderately predictive of cAPO at TP3 (AUC 0.756). Adding placental volume to clinical variables had moderate discrimination at all time points, with strongest test characteristics at TP3 (AUC 0.792) with sensitivity of 77.5 % and specificity of 75.3 % at a predicted probability cutoff of 15 %.
Discussion: MRI placental volume warrants further study for assessment of placental insufficiency, particularly later in gestation.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this article.
(Copyright © 2024 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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