The first screening test to predict a serious high blood pressure condition in pregnant women, pre-eclampsia, is being developed and could be in routine use by 2015.
And more of these personalised risk assessments are on the way to determine the likelihood that pregnant women will have a preterm birth, a baby with fetal growth restriction or a healthy pregnancy.
Robyn North, professor of maternal and fetal medicine at King's College in London, said her group had developed algorithms based on clinical risk factors in combination with specific proteins to predict pre-eclampsia.
The proteins have been identified via a biobank of 900,000 samples of blood, urine, and mouth swabs for DNA obtained from 5600 pregnant women as part of the international SCOPE study, which involves Australia, New Zealand, the UK and Ireland.
Professor North is leading the SCOPE study, which is measuring about 50 candidate biomarkers - proteins, metabolites and genes - for pre-eclampsia in order to refine the screening test for clinical use.
"The woman would have a blood sample taken at 15 weeks, then a specific set of three to eight proteins will be measured in the blood," she said. "Using these measurements, either alone or possibly in combination with a few clinical risk factors, the woman's risk of developing pre-eclampsia will be calculated."
Women at high risk of pre-eclampsia would be offered low-dose aspirin.
"Low-dose aspirin reduces the risk of pre-eclampsia by about 17 per cent but may be more effective if women at high risk are treated," Professor North said. "Most importantly, in randomised trials of more than 36,000 women, among those treated with low-dose aspirin the number of stillbirths and newborn baby deaths were reduced by 15 per cent."
Calcium supplementation might also reduce the risk of pre-eclampsia in women at high risk or who had low calcium in their diet, she said.
Pre-eclampsia, which can result in the mother having kidney or liver problems, stroke or seizures, affects 5 per cent of first-time mothers. Every year, the number of maternal deaths from pre-eclampsia worldwide is equivalent to the loss of 170 jumbo jets of pregnant women. One-third of babies born to mothers with pre-eclampsia are premature, one-quarter are growth restricted and the likelihood of perinatal death is increased three-fold.
"It can be a very frightening condition as within hours, a mother can go from feeling and being well to having a life-threatening illness," Professor North said. "Ultimately to cure the condition, the baby and placenta need to be delivered. A screening test is the first step to preventing this condition.
At present, women who are considered high risk are seen by obstetricians and are offered more intensive surveillance during their pregnancy."One of the best ways of telling who is at high risk of pre-eclampsia is if the pregnant woman has had the same problem in a previous pregnancy but this information is obviously not available for first-time mothers," Professor North said.
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