New test could lead to early detection of preeclampsia, doc says

A Brigham and Women’s Hospital doctor thinks he may have cracked the code to early detection of, Preeclampsia, a condition that affects about 7% of pregnancies and can lead to preterm deliveries as well as a twofold risk of future cardiovascular problems.

The early detection can then allow doctors to take steps to treat women at high risk for the disease that could in turn lead to better outcomes for their babies.

“We basically have a roadmap of what a normal pregnancy looks like,” said Dr. Thomas McElrath, of the Brigham’s Division of Maternal-Fetal Medicine, of his research. “We (could) then start to tell if someone is getting off into an abnormal pattern at a point prior to her clinical presentation.”

Using the test, which is done with a single blood draw at about 18 weeks in a woman’s pregnancy, McElrath was able to map out the week-by-week changes in the “kaleidoscope of thousands of genes that are expressed” in the blood, known as cell-free RNA, by both the mother and the fetus.

The resulting roadmap can not only show a sometimes more accurate account of a pregnancy’s stage, but can also predict preeclampsia, which McElrath used as a test case for this method.

The screening model, which identifies seven genes found in preeclampsia, produced a seven-fold improvement in correctly predicting the disease compared to current methods, and also identified 73% of people who ultimately had preeclampsia more than three months before symptoms appeared.

Armed with this knowledge, doctors could prescribe interventions for women at high risk of the disease including baby aspirin, anticoagulants, and medications that promote babies’ lung development, should they be delivered prematurely.

McElrath added that high-risk patients living in under-resourced areas could be transported to hospitals or areas that are better equipped to handle high-risk pregnancies. Patients could also be given blood pressure cuffs to monitor their own hypertension risk and send that data to their doctors.

Researchers may also be better able to recruit preeclamptic patients for studies to further improve outcomes with the disease.

Although McElrath said he thinks it’ll be a couple of years at least until this test is widely available, he hopes this technology will ultimately be used to detect other diseases, including gestational diabetes and spontaneous preterm birth.