New research funded by the British Heart Foundation (BHF) could pave the way for developing a test to predict pre-eclampsia in pregnant women and save the lives of mothers and babies across the world.
Pre-eclampsia is a common condition that only occurs during pregnancy. Women develop high blood pressure together with protein in their urine leaked from their kidneys, and fluid retention. Every year in the UK pre-eclampsia is responsible for the deaths of between seven and ten mothers and as many as 1,000 babies.
Findings from the University of Bristol suggest that measuring levels of the protein VEGF165b at 12 weeks of pregnancy may be a good indicator of the woman's risk of developing the condition. Such a test could ensure close monitoring and care of vulnerable pregnancies.
The BHF funded team, led by Professor Dave Bates from the University’s Department of Physiology and Pharmacology, built on previous studies suggesting the 'VEGF' family of proteins might be important in pre-eclampsia. They aimed to test whether one member of the family - VEGF165b - plays a role in developing the condition by tracking its abundance during pregnancy. As well as measuring VEGF165b in non-pregnant women, the team assessed VEGF165b levels in pregnant women at 12 weeks (end of the first trimester) and then at intervals throughout the pregnancy.
They found that in normal pregnancies there was a 10-fold increase in VEGF165b by the 12th week whilst in women who went on to develop pre-eclampsia, VEGF165b had barely increased by this stage. At full term there was statistically no significant difference between VEGF165b levels in healthy and pre-eclamptic pregnancies, suggesting that its increase is delayed in women who go on to develop pre-eclampsia. Measuring the protein at 12 weeks could therefore be useful in assessing a pregnant woman's risk of this condition.
Karen Partridge, 43 from Bristol suffered severe pre-eclampsia in her first two pregnancies. Karen said: “It was a very scary time. I spent 21 days in hospital during my first pregnancy. I had the classic symptoms, protein in my urine and high blood pressure and I swelled up like the Michelin man putting on four stone. There was no choice but to deliver my first child as quickly as possible, which resulted in a low birth weight of only 5lb 2oz and my daughter tube fed for ten days.
"I was very anxious about my second pregnancy as I again suffered pre-eclampsia with very similar symptoms. It was a frightening time for my family and I. Early detection would have prepared me for the symptoms of this condition and my pregnancy would have been more closely monitored."
Professor Jeremy Pearson, Associate Medical Director at the BHF said: "Developing a test to predict pre-eclampsia is a 'holy grail' in medicine. These researchers have made a vital finding that, if confirmed by other studies, has the potential to translate into a simple test that could potentially save many lives."
Dr Victoria Bills, Bristol University Clinical Research Fellow and the obstetrician who conducted the studies said: “Although there is currently no medicine to cure pre-eclampsia, a VEGF test could guide the prescription of aspirin - which decreases the incidence of pre-eclampsia by 15 per cent - and identify women that should be particular mindful of the symptoms, and who should be monitored closely by their doctor and midwife with regular fetal growth scans and blood pressure measurement. As this change occurs so early we still need to know whether the VEGF165b contributes to development of the condition, or is a consequence of early changes.”
Study published online by the journal Clinical Science: 'Failure to upregulate VEGF165b in maternal plasma is a first trimester predictive marker for pre-eclampsia'. V Bills et al. Clinical Science (2008) Immediate Publication, doi: 10.1042/CS20080270.