A blood test may one day be able to predict whether a pregnant person will develop a serious blood pressure disorder months before symptoms appear.
Preeclampsia occurs in about 1 in 20 pregnancies, usually in the third trimester, and can cause organ damage, stroke, and premature birth. Pregnancy-related high blood pressure disorders are among the leading causes of maternal death worldwide.
Although the blood test is still in development and won’t be available for some time, doctors and parent advocates say it could one day save lives.
Bekah Bischoff of Louisville, who developed preeclampsia in two pregnancies and now helps others with the disease, said she was diagnosed at the end of the third trimester each time. While pregnant with her son Henry in 2012, she discovered that she had a very serious type called HELLP syndrome at 36 weeks. It was delivered that day. She almost died.
“Just think of all the chaos and heartache and trauma, really, that went with it and that could have been avoided had there been a simple test that could have been done,” she said. .
The new experimental test involves detecting and analyzing chemical messages – a form of RNA – from the mother, baby and placenta. This would allow doctors to detect signs of preeclampsia as early as 16-18 weeks of pregnancy, before symptoms such as high blood pressure, swelling, and protein in the urine appear. Research published Wednesday in the journal Nature found that the test, developed by the South San Francisco-based company Mirvie, can correctly identify 75% of women who develop preeclampsia.
“It is often during the first trimester that much of the onset of the disease occurs biologically,” although symptoms appear late in pregnancy, said Maneesh Jain, CEO of Mirvie. Detecting preeclampsia after the onset of symptoms “leaves you very little time to meet the challenge. And it is especially crisis management.
Diagnosing preeclampsia now involves testing the urine for protein, measuring blood pressure, and doing other tests if suspected. Treatment may involve bed rest, medication, hospital monitoring, or induction of labor near the end of a pregnancy.
Previous studies have also suggested that circulating RNA could predict preeclampsia. But the authors of this study looked at a large and diverse dataset, analyzing RNA in 2,539 blood samples from 1,840 women in the United States, Europe and Africa to get a better idea of how a test might work. After the RNA messages were detected, a computer analyzed them for patterns. Although the test “robustly” predicted preeclampsia in those who contracted it, the study indicated that there were also people that it predicted would develop the disorder who did not. do.
Lead author of the study, Dr Thomas McElrath of Brigham and Women’s Hospital in Boston, hopes the test could also be used for the early detection of other pregnancy complications, such as gestational diabetes. Scientists said Mirvie’s approach reveals the underlying biology of healthy pregnancies. And by understanding what these normal RNA “profiles” look like, the researchers say they can find early indications of risks for other problems when these patterns differ in particular ways. More research is needed to take a close look at how the test might detect these other conditions, they said, and to further validate the results of preeclampsia.
Jain said it was too early to say when the test might be available to the public, but he might have a better idea of the timeline towards the end of the year. McElrath is a scientific advisor to Mirvie and has a financial interest in the company, as do other authors of the Nature article. Some are the inventors of patent applications covering the detection or treatment of pregnancy complications. The study was funded by Mirvie.
Dr S. Ananth Karumanchi of Cedars-Sinai in Los Angeles, who has done extensive research on preeclampsia but was not involved in the Nature study, said early detection of the disease would allow doctors to make simple adjustments, such as giving women low-dose aspirin. delay the onset of preeclampsia.
“There is no doubt that there is an unmet medical need,” Karumanchi said. Looking at the data in the article, he said, the scientists’ method “appears to be better than the current type of methods in use around the world.” If validated by further studies, “there would clearly be a need for something like this.”
Bischoff, who now works for the Preeclampsia Foundation, agreed. When she was around 5 months old with her son, she said, she felt low on energy and gained more weight than she thought. But when she asked members of her medical team about these kinds of issues, she recalls, she was told things were normal – like many other women she’s met who have had preeclampsia.
A blood test, she said, “would break down that barrier of having to fight to be heard.”
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