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Blood Test May Predict Preeclampsia

Protein Implicated in Life-Threatening Complication of Pregnancy
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Feb. 5, 2004 -- There's a major new development in predicting preeclampsia, a life-threatening condition that occurs in about one of every 20 pregnancies: Researchers say that before symptoms emerge, testing levels of two molecules in the blood can indicate which women will get the disease that results in some 76,000 deaths each year.

In a new study, Harvard and NIH researchers say they detected abnormal levels of two substances in women who went on to develop preeclampsia weeks before telltale symptoms: Elevated levels of a protein called soluble fms-like tyrosine kinase 1 (sFlt-1) and decreased amounts of another substance known as placental growth factor (PlGF). However, no such fluctuations occurred in women whose pregnancies remained normal.

The changing levels of these substances -- which were noted to occur five to six weeks before any symptoms became apparent -- are believed to cause a cascade of effects "that eventually impairs blood vessel growth in the placenta, as well as the mother's kidneys, liver, and possibly the brain," says lead researcher S. Ananth Karumanchi, MD, of Harvard's Beth Israel Deaconess Medical Center.

Danger to Baby and Mother

Preeclampsia affects some 200,000 American women each year and is the leading cause of pregnancy-related death and a major contributor to premature birth. This condition is primarily characterized by an increase in blood pressure that occurs after 20 weeks of pregnancy in a woman with previously normal blood pressure. These women also have lots of protein in the urine -- a sign of kidney damage. Swelling, sudden weight gain, headaches, and vision changes may also occur.

The condition can also lead to seizures in pregnant women -- a condition known as eclampsia. It can slow fetal growth, force premature delivery, and cause severe bleeding and death of the fetus and possibly the mother.

Until now, doctors have been hard-pressed in predicting which women will develop preeclampsia in pregnancy, dubbed "the disease of theories" because despite many theories of its origin, its exact cause has eluded experts. Typically, risk is assessed on factors such as existing diabetes, high blood pressure, being overweight, being age 35 or older, being of African-American race, and having a history of multiple births or previous preeclampsia.

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