Gadolinium during human pregnancy following administration of gadolinium chelate before pregnancy

Birth Defects Res. 2023 Aug 15;115(14):1264-1273. doi: 10.1002/bdr2.2209. Epub 2023 Jun 19.

Abstract

Gadolinium (Gd), a toxic rare earth element, has been shown to dissociate from chelating agents and bioaccumulate within tissues, raising concerns about the possibility of their remobilization during pregnancy with subsequent free Gd exposures to developing fetuses. Gd chelates are among the most commonly used magnetic resonance imaging (MRI) contrast agents. This investigation was undertaken after the detection of elevated Gd (800-1000× higher than the usual rare earth element levels) in preliminary unpublished studies from the placentae of subjects in the NIH ECHO/UPSIDE Rochester Cohort Study and unpublished studies from placentae analyzed in formalin-fixed placental specimens from Surgical Pathology at the University of Rochester. Fifteen pregnancies with elevated Gd were studied (12 first pregnancies and 3 second pregnancies). Maternal bloods were collected from all three trimesters, maternal, and cord (fetal) bloods at delivery as well as placental tissue. Breastmilk was also collected from selected mothers. It was determined that Gd was present in maternal bloods from all three trimesters, and in cord bloods and breastmilk in both first and second pregnancies. These results emphasize the need to fully appreciate the implications of pre-pregnancy exposure to Gd chelates and its potential effects on maternal and fetal health.

Keywords: breastmilk; gadolinium; human; maternal and cord bloods; pharmacokinetics; placenta; pregnancy.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Chelating Agents
  • Cohort Studies
  • Contrast Media* / adverse effects
  • Female
  • Gadolinium* / adverse effects
  • Gravidity
  • Humans
  • Mothers
  • Placenta / diagnostic imaging
  • Pregnancy

Substances

  • Contrast Media
  • Gadolinium
  • Chelating Agents