Predicting preeclampsia for safer pregnancies

RI-MUHC scientist Dr. Stella Daskalopoulou aims to reduce pregnancy complications by developing a reliable early screening tool

Preeclampsia is a serious pregnancy disorder affecting 2 to 10% of pregnancies worldwide, according to the World Health Organization. Women with preeclampsia have high blood pressure, and in serious cases, organ damage in the second half of pregnancy. If left untreated, this disease can put both mother and baby at risk of severe complications and even death.

Currently, there are no accurate screening tests to predict if a woman will develop preeclampsia until symptoms appear, which is often too late. A reliable early screening tool would ensure that at-risk women can access proper care early in pregnancy to keep themselves and their babies healthy. Unfortunately, no such tool exists at this time.

In a recent study, a team led by Dr. Stella Daskalopoulou, a scientist in the Cardiovascular Health Across the Lifespan Program of the RI-MUHC aimed to address the need for an early screening tool for preeclampsia.

“Effective prediction of preeclampsia would allow timely identification of pregnant women who would benefit most from preventive measures,” said Dr. Daskalopoulou. “It would ensure that limited health care resources are directed towards those women who are truly at high risk. This would in turn decrease the number of women who are wrongly considered “high-risk” and undergo excessive medical supervision during pregnancy.”

Her previous research has found that women destined to develop preeclampsia have greater arterial hardening throughout pregnancy, particularly in the second trimester, and midgestation sleep apnea is associated with increased arterial hardening and incraesed risk for preeclampsia. Because the hardening of the arteries can be performed safely and non-invasively, it may be a promising tool for early preeclampsia prediction.

The scientists used a measurement of arterial hardening called carotid femoral pulse wave velocity (cfPWV). The researchers found that cfPWV measurements functioned as a better predictor of preeclampsia in the first trimester than any of the other predictive tools currently used in clinical practice. Their results are the first evidence that measuring arterial hardening in the first trimester of pregnancy can help better predict preeclampsia.

Dr. Daskalopoulou is now leading a multinational prospective large study title study titled “Early Prediction of Preeclampsia Using arteriaL Stiffness in High-risk prEgnancies” (PULSE). The ongoing PULSE research study will measure the hardening of pregnant women’s arteries in the first trimester. It will compare the predictive performance of this measure to other known clinical risk factors for preeclampsia, as well as to alternative tools for detection of the disorder, like ultrasound and blood tests. The same assessments will also be performed in the second trimester to determine whether preeclampsia risk prediction can be improved.

“We anticipate that our work will help to identify preeclampsia much earlier than is currently possible, and thus contribute to the reduction of morbidity and mortality of pregnant women and babies around the world,” added Dr. Daskalopoulou.

Pulse is currently recruiting in 9 sites – 6 across Canada and 3 internationally. PULSE is fully funded by CIHR and Dr. Daskalopoulou’s top-ranked proposal received McGill University’s largest grant. Access more information about PULSE here.

The authors gratefully acknowledge funding by the Canadian Institutes of Health Research, Fonds de recherche du Québec - Santé, the Heart and Stroke Foundation, the Canadian Foundation of Woman’s Health, and the Academic Enrichment Fund from the Obstetrics Department at McGill University Health Centre. 

_ Source: RI-MUHC