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Feb. 9, 2022

Study could help predict a deadly pregnancy complication

A blood test could help doctors predict which pregnant women are likely to develop a life-threatening condition called preeclampsia, a study co-authored by a Michigan State University researcher found.

The test is more accurate than current methods of predicting preeclampsia, which is characterized by the onset of high blood pressure and excess protein in the urine, according to the study published in the journal Nature.

Seventy-five percent of women with preeclampsia were positive on this test. Among women who tested positive, 32% developed preeclampsia. Future research may increase prediction accuracy by combining these results with other biomarkers of preeclampsia, said Claudia Holzman, D.V.M., Masters in public health, Ph.D., a College of Human Medicine professor of epidemiology and biostatistics, and a collaborator of the study.

“It’s a beginning,” Holzman said. “This study also identified markers of pregnancy progress, a steppingstone for insights into how the biology is changing over the course of the pregnancy.”

Stored blood samples from eight diverse pregnancy cohorts were used to chart changes across pregnancy. Two of these cohorts specifically contributed to the preeclampsia analyses, including the Pregnancy Outcomes and Community Health, or POUCH, study, initiated by Holzman in 1998 to identify causes of preterm delivery. Hundreds of blood samples from women in that study were made available for this later study and were analyzed for levels of molecules called cell-free RNA. These biomarkers not only could help predict the risk of developing preeclampsia but could accurately determine how many weeks along a pregnancy is.

Initiators of this project included a San Francisco company called Mirvie that developed the test along with researchers from Brigham and Women’s Hospital in Boston and the University of Pennsylvania School of Medicine.

Although the current study focused on preeclampsia, similar approaches may be applicable to predicting other pregnancy complications, such as stillbirth and preterm birth.

Preeclampsia occurs in about 5%-7% of pregnancies and can damage multiple organ systems. It is a leading cause of severe maternal and neonatal illness and death. The disease generally appears late in pregnancy, although it often originates much earlier when the placenta is established.

Earlier diagnosis could help doctors more closely monitor the blood pressure of women at risk of developing preeclampsia and counsel them on the warning signs, Holzman said.

More than 350 blood samples from the POUCH study kept in a biorepository at MSU were submitted for analysis in this current study, she said.

“It’s a reminder that a study started long ago remains useful,” Holzman said. “It’s a gift that keeps on giving.”

“We’re honored to be part of this study,” she said, adding that the people who worked on these cohort studies and the women who enrolled are “important parts of the collaboration. Without their participation none of this would be possible.”

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