The main cause of maternal mortality is often overlooked. By the time it is diagnosed, it may be too late to stop the damage.
Doctors usually don’t identify preeclampsia, a severe form of high blood pressure that develops during pregnancy, until blood pressure and urine tests make it very obvious that symptoms have progressed and may be causing organ damage. . When cases are detected this late, women often go into premature labor, which affects both the baby and the mother.
Women of color, especially Black and Indigenous women, are at much higher risk of developing the disease due to pre-existing health issues.
The initiative announced this week aims to detect and treat pre-eclampsia earlier. If we can control preeclampsia, more women will be able to give birth. Treatment is as simple as prescribing aspirin to reduce or prevent symptoms. Researchers also hope this work will spur new treatments.
Tania Kanfaus, director of metabolic disorders at the nonprofit organization National Institutes of Health Foundationstates that even small preventive measures can “make a dramatic difference in a person’s life and in the life of their baby.” If it goes well, preeclampsia “affects both mother and child, not just during pregnancy and the first year after pregnancy, but throughout life,” she said.
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of The Centers for Disease Control and Prevention found 1,205 women died. The number of deaths from maternal causes in 2021 was up from 861 in 2020. The death rate for black women was more than twice that of her white counterparts. The CDC also determined that more than 80% of pregnancy-related deaths were deaths. preventable.
Nearly a third of pregnant women who died during childbirth had hypertension, including pre-eclampsia. According to the nonprofit organization, 10 to 15 percent of maternal deaths worldwide are caused by preeclampsia and related complications. March of Dimes. Preeclampsia can also occur after childbirth.
According to the Mayo Clinic, this condition usually develops around the middle of the 20th week of pregnancy, or after the 20th week of pregnancy. Preeclampsia is often detected by blood pressure tests. It is also often detected by a urine test that shows the patient has high protein levels. Other symptoms include low levels of platelets in the blood, increased liver enzymes, severe headaches, changes in vision, as well as shortness of breath due to fluid in the lungs, pain in the upper abdomen, nausea and vomiting.
However, doctors have limited ability to detect this condition in patients, and it is often only discovered when it is too late.
“In the United States, the way we detect someone’s risk of developing preeclampsia is purely clinical,” said Dr. Garita Sharma, director of American Cardiovascular Women’s Health and Cardio-Obstetrics. Inova Health Systemwho has We studied the risk of preeclampsia in the American black population. “There is no validated test that can be used to understand someone’s higher risk very early in pregnancy, or even early in the second trimester.”
Risk factors include having pre-eclampsia in a previous pregnancy, as well as chronic high blood pressure, diabetes, kidney disease, obesity and advanced maternal age, Sharma said. In addition to Indigenous women, Black women are also at greater risk. Women of color in the United States may have higher rates of chronic conditions that are considered risk factors for this disease.
If untreated, preeclampsia can cause organ damage and lead to premature birth. After that, women are at higher risk of heart failure and heart disease, Sharma said.
Detection of markers of pre-eclampsia
The three-year project, an NIH-driven nonprofit organization, aims to evaluate data on two biomarkers: placental growth factor (PlGF) and molecules indicating pregnancy-associated plasma protein A (PAPP-A). ing. I have pre-eclampsia.
The project is pulled from Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) data on more than 25,000 pregnancies in the United States and Canada, researchers say, will allow for an ethnically and racially diverse study group.
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Aaron Pawlik, director of NICHD’s Division of Obstetrics and Pediatric Pharmacology and Therapeutics, said this is important because existing data on how well biomarkers work are being generated in other countries. Ta. The data measure his PlGF and PAPP-A in blood collected from patients in a cohort study.
The presence of PlGF and PAPP-A does not mean the patient had preeclampsia, but it could help researchers identify high-risk patients, Pawlik said.
If these markers are detected, doctors will monitor these women more closely for changes in blood pressure, prioritizing Doppler ultrasound to check blood flow and blood tests to check liver enzyme levels. be able to. That way, Pawlik explained, the aspirin can be used sooner.
The project’s ultimate goal is to get the Food and Drug Administration to allow this type of detection. If approved by the FDA, the data will be made available to the public and companies will be able to develop diagnostic tests. That would allow companies to offer the test to pregnant patients during routine blood tests.
This could be useful not only for detection but also for the development of treatments. Kanfaus of the foundation said there are severe restrictions on using pregnant women for testing in clinical trials. Early testing may lead to the development of better treatments for preeclampsia.
Eduardo Cuevas covers health and breaking news for USA TODAY. You can contact him at: EMCuevas1@usatoday.com.
