MRI Findings in Third-Trimester Opioid-Exposed Fetuses, With Focus on Brain Measurements: A Prospective Multicenter Case-Control Study

Autor: Nagaraj, Usha D., Kline-Fath, Beth M., Zhang, Bin, Vannest, Jennifer J., Ou, Xiawei, Lin, Weili, Acheson, Ashley, Grewen, Karen, Grant, P Ellen, Merhar, Stephanie L.
Rok vydání: 2023
Předmět:
Zdroj: AJR Am J Roentgenol
ISSN: 1546-3141
0361-803X
DOI: 10.2214/ajr.22.28357
Popis: BACKGROUND: The opioid epidemic has profoundly affected infants born in the United States, as in utero opioid exposure increases risk of childhood cognitive and behavioral problems. Scarce literature has evaluated prenatal brain development in opioid-exposed fetuses. OBJECTIVE: To compare opioid-exposed and unexposed fetuses in terms of 2D biometric measurements of the brain and additional pregnancy-related assessments on fetal MRI. METHODS: This prospective case-control study included patients in the third trimester of pregnancy who underwent investigational fetal MRI at one of three U.S. academic medical centers from July 1, 2020 through December 31, 2021. Fetuses were classified as opioid-exposed or unexposed in utero. Fourteen 2D biometric measurements of the fetal brain were manually assessed and used to derive four indices. Measurements and indices were compared between the two groups using multivariable linear regression models, adjusting for gestational age (GA), fetal sex, and nicotine exposure. Additional pregnancy-related findings on MRI were evaluated. RESULTS: The study included 65 women (mean age, 29.0±5.5 years). A total of 28 fetuses (mean GA, 32.3±2.5 weeks) were opioid-exposed, and 37 fetuses (mean GA, 31.9±2.7 weeks) were unexposed. In the adjusted models, seven measurements were smaller (p.05). Fetal motion, cervical length, and deepest vertical pocket of amniotic fluid were not significantly different (p>.05) between groups. Opioid-exposed fetuses, compared with unexposed fetuses, showed higher frequencies of breech position (21% vs 3%, p=.03) and of increased amniotic fluid volume (29% vs 8%, p=.04). CONCLUSION: Fetuses with in utero opioid exposure had smaller brain size and altered fetal physiology. CLINICAL IMPACT: The findings provide insight into the impact of prenatal opioid exposure on fetal brain development.
Databáze: OpenAIRE
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