Prediction of low birth weight: Comparison of placental T2* estimated by MRI and uterine artery pulsatility index

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  • Marianne Sinding, Department of Obstetrics and Gynecology, Aalborg University Hospital, Denmark
  • David A. Peters
  • Jens B. Frøkjær, Aalborg University Hospital, Denmark
  • Ole B. Christiansen
  • Astrid Petersen, Aalborg University Hospital, Denmark
  • Niels Uldbjerg
  • Anne Sørensen, Department of Obstetrics and Gynecology, Aalborg University Hospital, Denmark

Objective Neonates at low birth weight due to placental dysfunction are at high risk of adverse outcomes. These outcomes can be substantially improved by prenatal identification. The Magnetic Resonance Imaging (MRI) constant, placental T2* reflects placental structure and oxygenation and thereby placental function. Therefore, we aimed to evaluate the performance of placental T2* in the prediction of low birth weight using the uterine artery (UtA) pulsatility index (PI) as gold standard. Methods This was a prospective observational study of 100 singleton pregnancies included at 20–40 weeks' gestation. Placental T2* was obtained using a gradient recalled multi-echo MRI sequence and UtA PI was measured using Doppler ultrasound. Placental pathological examination was performed in 57 of the pregnancies. Low birth weight was defined by a Z-score ≤ −2.0. Results The incidence of low birth weight was 15%. The median time interval between measurements and birth was 7.3 weeks (interquartile range 3.0, 13.7 weeks). Linear regression revealed significant associations between birth weight Z-score and both placental T2* Z-score (r = 0.68, p < 0.0001) and UtA PI Z-score (r = −0.43, p < 0.0001). Receiver operating characteristic curves demonstrated a significantly higher performance of T2* (AUC of 0.92; 95% CI, 0.85–0.98) than UtA PI (AUC of 0.74; 95% CI, 0.60–0.89) in the prediction of low birth weight (p = 0.010). Placental pathological findings were closely related to the T2* values. Conclusions In this population, placental T2* was a strong predictor of low birth weight and it performed significantly better than the UtA PI. Thus, placental T2* is a promising marker of placental dysfunction which deserves further investigation.

Original languageEnglish
JournalPlacenta
Volume49
Pages (from-to)48-54
Number of pages7
ISSN0143-4004
DOIs
Publication statusPublished - 1 Jan 2017

    Research areas

  • Birth weight, Magnetic resonance imaging, Placental dysfunction, Placental hypoxia, T2*, Transverse relaxation

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