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Dramatic Increase in CT Imaging During Pregnancy

By MedImaging International staff writers
Posted on 05 Aug 2019

A new study reveals a four-fold rise over the last two decades in the number of pregnant women undergoing computed tomography (CT) scans, which expose both mother and fetuses to radiation.

Researchers at Kaiser Permanente Northern California (Oakland, USA), the University of California, San Francisco (UCSF; USA), the University of Toronto (UT; Canada) and other institutions conducted a retrospective cohort study to evaluate patterns of medical imaging--CT, magnetic resonance imaging (MRI), conventional radiography, angiography, fluoroscopy, and nuclear medicine--during pregnancy at six US integrated health care systems and in Ontario (Canada). The main outcomes and measures were imaging rates per pregnancy, stratified by country and year of child’s birth.

A total of 3,497,603 pregnancies were analyzed during the 21-year study period. The results revealed that CT imaging rates in the United States increased from two examinations per 1,000 pregnancies in 1996 to 11.4 in 2007, remained stable through 2010, and decreased to 9.3 pregnancies by 2016, for an overall increase of 3.7-fold. CT rates in Ontario increased by two fold, from two per 1,000 pregnancies in 1996 to 6.2 in 2016. Overall, 5.3% of pregnant women in the US sites and 3.6% in Ontario underwent imaging with ionizing radiation, with 0.8% US of women and 0.4% Canadian women undergoing CT.

MRI rates also increased steadily, from one per 1,000 pregnancies in 1996 to 11.9 in 2016 in the United States, and from 0.5 per 1,000 in 1996 to 9.8 in 2016 in Ontario, surpassing CT rates. Angiography, fluoroscopy, and nuclear medicine use rates were low, but in most years were higher in Ontario than in the United States. Imaging rates were highest for women who were younger than 20 years, 40 years or older, gave birth preterm, or were black, Native American or Hispanic. The study was published on July 24, 2019, in JAMA Network Open.

“CT scans provide the clearest images, they can be done quickly, and are less expensive and more widely available. However, CT scans have the most ionizing radiation and they are commonly done in places of the body where the fetus is exposed to the radiation,” said senior author Professor Rebecca Smith-Bindman, MD, of UCSF. “Imaging can be helpful, but it can be overused. Always, but especially if you're pregnant, you should ask whether it is really medically necessary to have any imaging test that involves ionizing radiation.”

Ionizing radiation exposure is associated with potential carcinogenic, teratogenic and mutagenic health risks to the developing fetus, with characterization and severity dependent on the gestational age at the time of exposure and radiation dose to the fetus. As a result, ultrasonography has replaced abdominal radiographs for monitoring pregnancy-related complications.

Related Links:
Kaiser Permanente Northern California
University of California, San Francisco
University of Toronto

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67 (25.98762512207): select jos_linkedin.link from jos_linkedin where cat=10

68 (35.04753112793): SELECT fid FROM jos_deeppockets WHERE id=294778863 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294778863 AND published='1' LIMIT 1

69 (30.994415283203): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=215 ORDER BY `ordering`

70 (340.93856811523): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294778863 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (233.17337036133): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294778863 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (60.081481933594): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (48.160552978516): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (61.03515625): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (26.226043701172): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (67.949295043945): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294778863 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (30.040740966797): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294778863 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (31.948089599609): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (63.896179199219): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (45.061111450195): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (60.081481933594): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (54.121017456055): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (81.062316894531): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778863 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778863 AND published='1' LIMIT 1

105 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778863 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778863 AND published='1' LIMIT 1

106 (69.141387939453): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294778863 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (65.088272094727): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294778863 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (753.16429138184): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778863 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778863 AND published='1' LIMIT 1

109 (108.00361633301): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778863 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778863 AND published='1' LIMIT 1

110 (910.99739074707): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294778863 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (!!!!! 2413.9881134033): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294778863 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (738.14392089844): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (608.92105102539): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (131.84547424316): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778863 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778863 AND published='1' LIMIT 1

115 (52.928924560547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778863 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778863 AND published='1' LIMIT 1

116 (102.99682617188): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778863 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778863 AND published='1' LIMIT 1

117 (59.127807617188): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778863 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778863 AND published='1' LIMIT 1

118 (94.890594482422): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778863 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778863 AND published='1' LIMIT 1

119 (44.107437133789): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778863 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778863 AND published='1' LIMIT 1

120 (377.17819213867): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 167418.00308228): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

122 (229.1202545166): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778863 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778863 AND published='1' LIMIT 1

123 (165.93933105469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778863 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778863 AND published='1' LIMIT 1

124 (!!!!! 4636.0492706299): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294778863 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294778863 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 1137804.0313721): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (100.85105895996): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (51.975250244141): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

128 (28.848648071289): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

129 (50.067901611328): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

130 (29.802322387695): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

131 (30.040740966797): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

132 (27.894973754883): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

133 (553.84635925293): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778863 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (487.08915710449): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778863 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (60.796737670898): SELECT name FROM jos_deeppockets WHERE id=215

136 (40.054321289062): SELECT name FROM jos_deeppockets WHERE id=215

137 (636.10076904297): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

138 (560.99891662598): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

139 (101.08947753906): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778863 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778863 AND published='1' LIMIT 1

140 (69.856643676758): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778863 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778863 AND published='1' LIMIT 1

141 (!!!!! 9131.908416748): TRUNCATE TABLE jos_trademed_module

142 (112.05673217773): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294778863 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (54.836273193359): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294778863 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (860.92948913574): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778863 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (70.095062255859): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778863 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (76.055526733398): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778863 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778863 AND published='1' LIMIT 1

147 (50.067901611328): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778863 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778863 AND published='1' LIMIT 1

148 (!!!!! 1184.9403381348): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

149 (112.05673217773): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778863 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778863 AND published='1' LIMIT 1

150 (82.015991210938): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778863 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778863 AND published='1' LIMIT 1

151 (72.002410888672): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294778863 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294778863 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (50.067901611328): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

153 (41.961669921875): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

154 (65.803527832031): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (76.055526733398): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778863 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778863 AND published='1' LIMIT 1

156 (46.968460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778863 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778863 AND published='1' LIMIT 1

157 (48.87580871582): select jos_twitters.link from jos_twitters where cat=10

158 (41.961669921875): select jos_facebook.link from jos_facebook where cat=10

159 (42.915344238281): select jos_google_plus.link from jos_google_plus where cat=10

160 (33.140182495117): select jos_linkedin.link from jos_linkedin where cat=10

161 (248.90899658203): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 1338.9587402344): insert into jos_banners_delta values (14615,'2025-06-19 12:19:10','216.73.216.120','view'),(14202,'2025-06-19 12:19:10','216.73.216.120','view'),(14203,'2025-06-19 12:19:10','216.73.216.120','view')

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