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Novel Blood Test Offers Early Preeclampsia Risk Detection
Preeclampsia, a serious hypertensive disorder of pregnancy and a primary cause of pregnancy-related deaths in the United States, often presents detection challenges in its early stages. However, a groundbreaking blood test has emerged, offering the potential to identify a pregnant woman’s likelihood of developing this condition months before clinical symptoms manifest. This innovative diagnostic tool may revolutionize prenatal care by enabling earlier interventions and improved maternal outcomes.
Identifying High-Risk Pregnancies
Maneesh Jain, from Mirvie, a health technology company based in California, highlights the test’s precision: “We can refine the risk assessment to approximately one in four pregnancies truly at high risk, representing a significant advancement in early detection.”
Understanding Preeclampsia and its Challenges
Preeclampsia is classified as a hypertensive disorder of pregnancy (HDP), arising from placental development issues, although the exact mechanisms remain under scientific investigation. This condition triggers elevated blood pressure, potentially leading to cardiovascular complications, organ impairment, seizures, and even fatalities for the mother. Furthermore, it poses risks to the developing fetus.
Early identification of preeclampsia and other HDPs is often hindered because noticeable symptoms typically do not appear until at least the 20th week of gestation, and sometimes remain undetected until labor commences. Moreover, direct monitoring of placental development via tissue sampling is considered highly invasive.
RNA Markers for Predictive Testing
The newly developed blood test offers a less invasive approach, utilizing RNA markers to predict the probability of developing an HDP. This analysis concentrates on specific genes, notably PAPPA2 and CD163, whose overexpression has been previously correlated with HDPs. Researchers investigated whether this genetic overexpression could be identified through blood analysis.
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Validation Study Demonstrates High Accuracy
A validation study involving over 9,000 pregnant participants indicated promising results. Jain reports that the test accurately predicted with over 99 percent precision whether individuals without pre-existing risk factors exhibited overexpression of these genes, thus indicating a high risk of preeclampsia or another HDP. Approximately one-quarter of participants without known HDP risk factors displayed gene overexpression.
Risk Factors and Early Intervention
Morten Rasmussen, also from Mirvie, points out that certain populations, such as those with pre-existing hypertension or a family history of preeclampsia, are already recognized as having a moderately increased risk. However, for many women, the onset of preeclampsia appears unexpectedly.
Knowing of an elevated preeclampsia risk allows for proactive preventative measures. Standard interventions include low-dose aspirin therapy, adoption of a Mediterranean diet, and daily blood pressure monitoring.
Timing Considerations for Intervention
However, Kathryn Gray at the University of Washington in Seattle notes a critical timing limitation. The current study population was between 17.5 and 22 weeks of gestation. “Ideally, aspirin treatment should commence before 16 weeks,” Gray explains. “Therefore, the window for optimal aspirin intervention is missed by the time test results are typically available.”
Future Availability and Therapeutic Potential
Mirvie intends to launch the blood test commercially soon. The company anticipates that broader market availability will encourage further research into therapies precisely targeting genes like PAPPA2. Rasmussen suggests that such molecular precision in identifying risk factors “offers an improved likelihood for treatments to be effective.”
Refining Risk Profiles and Accessibility
Gray also encourages researchers to utilize Mirvie’s RNA data repository to further refine the understanding of genes contributing to preeclampsia risk in specific populations. Refining the genetic profile could lead to cost reductions for the test, potentially enhancing its accessibility to a wider population, she concludes.