Blood test may one day predict severe pregnancy complication

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Blood tests may someday predict whether a pregnant person will develop a serious blood pressure disorder months before symptoms appear.

Pre-eclampsia occurs about 1 in 20 pregnancies, usually in late pregnancy, and can cause organ damage, stroke, and preterm birth. Pregnancy-related hypertension disorders are one of the leading causes of maternal death worldwide.

Blood tests are still under development and will not be available for some time, but doctors and parent advocates say they can save lives someday.

Bekah Bischoff of Louisville said she developed pre-eclampsia during two pregnancies and is helping others who are currently in this condition, she was diagnosed in the second half of both pregnancies. When she was pregnant with her son Henry in 2012, she noticed at week 36 that she had a very severe type of syndrome called HELLP syndrome. He was delivered that day. She almost died.

“Think about all the turmoil and broken hearts, and all the trauma. In fact, that could have been avoided with a simple test that could have been done,” she said.

A new experimental test detects and analyzes chemical messages (a type of RNA) from the mother, baby, and placenta. This allows doctors to detect signs of preeclampsia 16-18 weeks gestation before symptoms such as high blood pressure, swelling, and proteinuria appear.A study published in the journal on Wednesday Nature A test developed by South San Francisco-based company Mirvie found that it could correctly identify 75% of women who continue to develop pre-eclampsia.

Although symptoms appear late in pregnancy, “many of the symptoms occur biologically, often in the early stages of pregnancy,” said Maneesh Jain, CEO of Mirvie. Detecting pre-eclampsia after symptoms occur “has little time to tackle the challenge, and it’s primarily crisis management.”

Diagnosis of pre-eclampsia includes urinary protein tests, blood pressure measurements, and other tests if in doubt. Treatment includes rest, dosing, hospital monitoring, or inducing labor near the end of pregnancy.

Early studies have also suggested that circulating RNA can predict pre-eclampsia. However, the authors of this study examined a large and diverse data set and analyzed RNA from 2,539 blood samples from 1,840 women in the United States, Europe, and Africa to see how the test works. I understood better. After the RNA messages were detected, the computer analyzed those patterns. The test “firmly” predicted pre-eclampsia, but studies have shown that some people who predicted pre-eclampsia did not develop pre-eclampsia.

Dr. Thomas Machaerus of Brigham and Women’s Hospital in Boston, the lead author of the study, hopes that the test can also be used for early detection of other pregnancy complications such as gestational diabetes. Scientists said Marby’s approach reveals the underlying biology of a healthy pregnancy. And by understanding what those normal RNA “profiles” look like, researchers can find early signs of risk for other problems if these patterns differ in a particular way. Is called. They said further research is needed to scrutinize how the test detects these other conditions and further validate the results of pre-eclampsia.

Jane said it’s too early to say when the test will be open to the public, but he may have a better idea of ​​when to end the year. McElrath is Mirvie’s scientific adviser and, like the other authors of the Nature paper, has an economic interest in the company. Some inventors have applied for patents to detect or treat pregnancy complications. The study was paid by Mirvie.

Dr. S. Ananth Karumanchi of Cedars-Sinai, Los Angeles, who conducted extensive research on pre-eclampsia but was not involved in natural studies, said that early detection of the condition allowed doctors to lower doses to women. To delay the onset of pre-eclampsia, which stated that simple adjustments such as giving aspirin can be made.

“There is no doubt that there are clearly unmet medical needs,” Kalmanchi said. Looking at the data in the paper, he said, the scientist’s method “looks better than the current kind of method used around the world.” If verified by other studies, “obviously you will need something like that.”

Bischoff, who is currently working at the Pre-eclampsia Foundation, agreed. About five months with her son, she felt energy wasted and said she was gaining more weight than she had expected. But when she asked people on the medical team about this kind of problem, she remembered that, like many other women with pre-eclampsia, things were said to be normal. ..

A blood test “will remove that barrier of having to fight to hear,” she said.


RNA sequences from a single blood draw can predict pregnancy health and pre-eclampsia


For more information:
Morten Rasmussen, RNA profile reveals signs of future health and illness during pregnancy, Nature (2022). DOI: 10.1038 / s41586-021-04249-w.. www.nature.com/articles/s41586-021-04249-w

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