About 1 in 5 US women had imaging with ionizing radiation during pregnancy

  • JAMA Netw Open

  • Elisabeth Aron, MD, MPH, FACOG
  • Clinical Essentials
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Takeaway

  • About 1 in 5 US women has had imaging with ionizing radiation during pregnancy.

Why this matters

  • Imaging studies are often important for diagnosing serious surgical conditions during pregnancy.
  • However, they are often avoided or delayed because of concerns about potential fetal harm from ionizing radiation exposure.

Key results

  • Overall, 5.3% of pregnant US women and 3.6% of Ontario women underwent imaging with ionizing radiation, 1996-2016.
  • The percentage of pregnancies with imaging ranged from:
    • CT: 0.4%-1.1%;
    • MRI: 0.4%-1.4%;
    • Conventional radiology: 3.1%-8.0%; and
    • Angiography and fluoroscopy: 0.2%-0.5%.
  • Racial disparities in imaging rates were noted (black women had higher rates compared with white women).
  • US CT use rates increased from 2.0/1000 pregnancies in 1996 to 11.4/1000 in 2007 and then decreased to 9.3/1000 in 2016.
  • The use of MRI is increasing compared with CT (2011-2016):
    • US: 12.8 vs 10.6 per 1000.
    • Ontario: 9.8 vs 6.2 per 1000.

Study design

  • Retrospective cohort study.
  • Cohort taken from 6 integrated health care systems in the United States and Canada (n=3,497,603).
  • Main outcome was imaging rate per pregnancy.
  • Funding: National Cancer Institute, Institute for Clinical Evaluative Sciences.

Limitations

  • Undercalculation possible because of repeat exams.