A new study has found biomarkers could predict severe pre-eclampsia, preventing death and serious illness in women.
In a study of pregnant women in the United States, Cedars-Sinai investigators discovered that a specific imbalance of two placental proteins could predict which women were at risk of developing severe pre-eclampsia.
Pre-eclampsia is a condition that affects some pregnant women, usually in the second trimester or after the baby is delivered. Early signs include having high blood pressure and protein in your urine. These symptoms are typically picked up during routine antenatal appointments.
The study is published in the journal of NEJM Evidence.
Is severe pre-eclampsia predictable?
The blinded, prospective study of women initially hospitalised for pre-term hypertension involved 1,014 patients from 18 hospitals across the United States.
The team discovered that a specific protein imbalance revealed in blood tests of the hospitalised pregnant women provided a way to quantify their risk of developing severe pre-eclampsia. The process involved levels of soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factor (PIGF) in the bloodstream.
“An sFlt-1 to PIGF ratio of 40 or greater predicted the development of serious preeclampsia, adverse outcomes and early delivery within two weeks, two-thirds of the time,” said S Ananth Karumanchi, MD, the co-senior author of the study, who holds the Medallion Chair in Vascular Biology.
“Conversely, if the critical ratio between the two proteins was below 40, we found the risk that the patient would progress to preeclampsia with severe features within two weeks of the blood test was less than 5%,” said Karumanchi, who is also director of Nephrology at Cedars-Sinai.
Changing the future of pregnancy care
The only cure for pre-eclampsia is delivery. However, a test that indicates that a preterm patient, which is a woman who has completed less than 37 weeks of pregnancy, is likely to develop severe pre-eclampsia could improve care.
“We anticipate that this blood test may eventually lead to better health outcomes for mothers and their babies,” said Kilpatrick. “It is well known that preeclampsia advances in virtually all patients until they give birth. But it can be very hard to predict the optimal time for delivery. Having an accurate test would help us ensure that the mother was in the right hospital for management of her care and that of her preterm baby.”
Rates of severe pre-eclampsia are on the rise and the researchers hope that their discoveries could point toward potential treatments for women at risk.
“We know sFlt-1 is the protein that goes up even before any symptoms of preeclampsia occur and the ratio of sFlt-1 to PlGF predicts worsening disease,” said Karumanchi. “Further research may identify a drug mechanism that could reduce levels of sFlt-1 and be used to safely prolong pregnancy; that would be a game-changer for very preterm preeclampsia patients.”
