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CC BY-NC-ND 4.0 · Am J Perinatol 2024; 41(S 01): e853-e862
DOI: 10.1055/a-1961-2059
Original Article

A Description of the Imaging Innovations for Placental Assessment in Response to Environmental Pollution Study

Carla Janzen   *
1   Department of Obstetrics and Gynecology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California
,
Margarida Y. Y. Lei
1   Department of Obstetrics and Gynecology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California
,
Brian R. Lee
2   Department of Pediatrics, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California
,
Sitaram Vangala
3   Department of Internal Medicine and Health Services Research, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California
,
Irish DelRosario
4   Department of Epidemiology, Jonathan Fielding School of Public Health at University of California Los Angeles, Los Angeles, California
,
Qi Meng
4   Department of Epidemiology, Jonathan Fielding School of Public Health at University of California Los Angeles, Los Angeles, California
,
Beate Ritz
4   Department of Epidemiology, Jonathan Fielding School of Public Health at University of California Los Angeles, Los Angeles, California
,
Jonathan Liu
5   Department of Environmental Health Sciences, Jonathan Fielding School of Public Health at University of California Los Angeles, Los Angeles, California
,
Michael Jerrett
5   Department of Environmental Health Sciences, Jonathan Fielding School of Public Health at University of California Los Angeles, Los Angeles, California
,
Teresa Chanlaw
2   Department of Pediatrics, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California
,
Sarah Choi
2   Department of Pediatrics, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California
,
Arya Aliabadi
3   Department of Internal Medicine and Health Services Research, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California
,
Precious Ann Fortes
6   Department of Pathology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California
,
Peggy S. Sullivan
6   Department of Pathology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California
,
Aisling Murphy
1   Department of Obstetrics and Gynecology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California
,
Giorgia Del Vecchio
2   Department of Pediatrics, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California
,
Shanthie Thamotharan
2   Department of Pediatrics, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California
,
KyungHyun Sung    *
7   Department of Radiology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California
,
Sherin U. Devaskar   *
2   Department of Pediatrics, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California
› Author Affiliations Funding This work was supported by the NIH-U01 HD087221 (multi-PI to S.U.D., K.S., and C.J.) and NICHD HD089714 and HD100015 (to S.U.D.).
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Abstract

Objective The aim of Placental Assessment in Response to Environmental Pollution Study (PARENTs) was to determine whether imaging of the placenta by novel multiparametric magnetic resonance imaging (MRI) techniques in early pregnancy could help predict adverse pregnancy outcomes (APOs) due to ischemic placental disease (IPD). Additionally, we sought to determine maternal characteristics and environmental risk factors that contribute to IPD and secondary APOs.

Study Design Potential patients in their first trimester of pregnancy, who agreed to MRI of the placenta and measures of assessment of environmental pollution, were recruited into PARENTs, a prospective population-based cohort study. Participants were seen at three study visits during pregnancy and again at their delivery from 2015 to 2019. We collected data from interviews, chart abstractions, and imaging. Maternal biospecimens (serum, plasma, and urine) at antepartum study visits and delivery specimens (placenta, cord, and maternal blood) were collected, processed, and stored. The primary outcome was a composite of IPD, which included any of the following: placental abruption, hypertensive disease of pregnancy, fetal growth restriction, or a newborn of small for gestational age.

Results In this pilot cohort, of the 190 patients who completed pregnancy to viable delivery, 50 (26%) developed IPD. Among demographic characteristics, having a history of prior IPD in multiparous women was associated with the development of IPD. In the multiple novel perfusion measurements taken of the in vivo placenta using MRI, decreased high placental blood flow (mL/100 g/min) in early pregnancy (between 14 and 16 weeks) was found to be significantly associated with the later development of IPD.

Conclusion Successful recruitment of the PARENTs prospective cohort demonstrated the feasibility and acceptability of the use of MRI in human pregnancy to study the placenta in vivo and at the same time collect environmental exposure data. Analysis is ongoing and we hope these methods will assist researchers in the design of prospective imaging studies of pregnancy.

Key Points

  • MRI was acceptable and feasible for the study of the human placenta in vivo.

  • Functional imaging of the placenta by MRI showed a significant decrease in high placental blood flow.

  • Measures of environmental exposures are further being analyzed to predict IPD.

Keywords

placental imaging - ischemic placental disease - adverse pregnancy outcomes - MRI - environmental exposures

* These authors are the equal contributors to the overarching study concept, design, methods, and execution of the study.




Publication History

Received: 20 April 2022

Accepted: 22 September 2022

Accepted Manuscript online:
14 October 2022

Article published online:
05 December 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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