Prenatal alcohol exposure affects placental degradation—a retrospective fetal MRI study

Abstract Objectives To provide initial insights into structural placental anomalies following prenatal alcohol exposure (PAE) utilizing routine human fetal MRI. Materials and methods This retrospective study investigated 29 fetuses (mean gestational age 26.1 weeks, SD 3.7 weeks) subjected to PAE (PAE+) without confounding comorbidities and 29 age-matched controls without PAE (PAE−). Assessment of the placenta was performed using 1.5- and 3-T fetal MRI scans and included analysis of twelve structural parameters. Results This study provides the first data on in vivo fetal MRI results regarding the effects of PAE on placenta structure. We identified an association of PAE with increased occurrence rates of placental lobulation, venous congestion, any type of placental hematoma, subamniotic hematoma on the placental surface, specifically, and hypercoiled umbilical cord. A trend was observed with increased placental lobulation occurring at earlier gestational ages in PAE+ patients. Overall, more structural placental anomalies were detected in women with PAE compared to unexposed controls, despite a relatively low amount of alcohol consumption (1–3 drinks per week) within the exposed group. Conclusion Early detection of PAE is essential, considering the potentially detrimental effects of ethanol on placental structure. Fetal MRI provides a complementary tool for ultrasound-based assessment of fetus and placenta, not only in cases with congenital disorders, but also to assess effects of epigenetic factors such as PAE. Key Points Question To assess the presence of structural placental anomalies in patients with PAE and unexposed controls in fetal MRI . Findings PAE is associated with increased occurrence rates of placental abnormalities - regarding the total number and type of structural anomalies . Clinical relevance Fetal MRI provides a complementary tool to ultrasound to assess the placenta. Early detection of structural placental anomalies, which were found to occur more frequently in alcohol exposed fetuses, may aid counseling physicians in choosing appropriate pregnancy management plans . Graphical Abstract