A Description of the Imaging Innovations for Placental Assessment in Response to Environmental Pollution Study.
A Description of the Imaging Innovations for Placental Assessment in Response to Environmental Pollution Study.
复制标题
环境污染研究中胎盘评估成像创新的描述。
DOI：
10.1055/a-1961-2059
复制
发表时间：
2022
影响因子：
2
通讯作者：
Vecchio,
中科院分区：
文献类型：
--
作者：
Janzen,Carla;Lei,MargaridaYY;Lee,BrianR;Vangala,Sitaram;DelRosario,Irish;Meng,Qi;Ritz,Beate;Liu,Jonathan;Jerrett,Michael;Chanlaw,Teresa;Choi,Sarah;Aliabadi,Arya;Fortes,PreciousAnn;Sullivan,PeggyS;Murphy,Aisling;Vecchio,
目的评估胎盘对环境污染的反应研究(Parents)的目的是确定在妊娠早期用新的多参数磁共振成像(MRI)技术对胎盘进行成像是否有助于预测缺血性胎盘疾病(IPD)导致的不良妊娠结局(APOS)。此外，我们试图确定导致IPD和继发性APO的母亲特征和环境风险因素。研究设计怀孕前三个月的潜在患者，他们同意对胎盘进行核磁共振检查和环境污染评估措施，被招募到父母中，这是一项基于人群的前瞻性队列研究。2015年至2019年，参与者在怀孕期间进行了三次学习访问，并在分娩时再次进行了研究。我们从访谈、图表摘要和成像中收集数据。在产前研究访问和分娩标本(胎盘、脐带和母血)时收集、处理和储存母体生物标本(血清、血浆和尿液)。主要结果是IPD的综合结果，其中包括以下任何一项：胎盘早剥、妊娠高血压疾病、胎儿生长受限或小于胎龄的新生儿。结果在这一试点队列中，在190名完成妊娠到存活分娩的患者中，50例(26%)发生了IPD。在人口学特征中，经产妇有IPD病史与IPD的发生有关。结果显示，妊娠早期(14~16周)胎盘高血流量(m L/10 0 g/m in)的减少与妊娠晚期IPD的发生密切相关。结论成功招募双亲前瞻性队列，证明了在孕期应用磁共振技术研究胎盘的可行性和可接受性，同时收集环境暴露资料。分析正在进行中，我们希望这些方法将有助于研究人员设计怀孕的前瞻性成像研究。
ObjectiveThe 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 DesignPotential 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.ResultsIn 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.ConclusionSuccessful 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