Blood test in early pregnancy could help predict preeclampsia

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Australia; International; VIC
Photo by Ignacio Campo on Unsplash
Photo by Ignacio Campo on Unsplash

A new blood test done in early pregnancy could help predict who is at risk of pre-eclampsia, finds international research. Pre-eclampsia is a serious complication of pregnancy that claims the lives of 60,000 women every year around the world. The new test looks for changes to the chemical tagging of DNA, known as methylation, in the mother's blood.  The researchers found that DNA floating outside of cells in the blood is altered in women who developed preterm pre-eclampsia compared to those who did not. An accompanying News and Views article, by University of Melbourne experts, highlights that while this new test falls short of the current test in performance (57% versus 75% sensitivity), it is simpler to use, which may have benefits.

Media release

From: Springer Nature

Health: A blood-derived biomarker to enhance the early prediction of preeclampsia (N&V)

A liquid-biopsy approach that measures DNA-methylation levels in the blood may improve the detection of pregnancies at risk of developing preeclampsia at early stages, a study published in Nature Medicine shows.

Preeclampsia is a major cause of morbidities during gestation. Early-onset preeclampsia — occurring before 34 weeks of gestation — is associated with a higher risk of severe disease and fetal mortality. Among the few interventions available, low-dose aspirin at early stages of the disease (before 16 weeks of gestation) can reduce the risk of developing preeclampsia, but early identification of the disease is needed to initiate this intervention. Previous studies have shown that widespread methylation changes in the placenta occur at delivery. Liquid biopsy is a promising emerging tool for non-invasive diagnostics, and it is increasingly being used to detect disease and monitor progression and treatment response.

Bernard Thienpont and colleagues profiled blood DNA-methylation data from 498 pregnant women, about one third of whom developed preeclampsia. The authors detected differences in DNA methylation in the control pregnancies versus the pregnancies that developed preeclampsia. Using these data, they developed a model that enabled risk stratification not only when preeclampsia was diagnosed but also presymptomatically, at around 12 weeks of gestation. In a further analysis involving 197 of these women, they showed that this model, in combination with clinical and demographic risk factors already used in the clinic, generated a risk score that correctly predicted 72% of patients with early-onset preeclampsia.

The authors indicate that blood-based analysis of DNA methylation has the potential to improve the risk prediction of preeclampsia at the early stages. However, they note that future research and prospective studies are needed to further validate the clinical utility of the approach.

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conference:
Nature Medicine
Research:Paper
Organisation/s: KU Leuven, Belgium, The University of Melbourne (News and Views article only- not involved in the research)
Funder: This study was supported by Research Foundation – Flanders (FWO), grant nos. 1524119 N (to B.T. and J.R.V.), S003422N (to J.R.V. and B.T.) and G0B4822N and G0C7519N (to B.T.); by KU Leuven Bijzonder Onderzoeksfonds, grant no. 3M180296 (to B.T.); and by a KU Leuven C1 grant (to J.R.V. and B.T.). M.D.B. and M.A. are supported by a Research Foundation – Flanders (FWO) fellowship and B.T. by a BOFZAP mandate.
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