Research Sets Stage for Preeclampsia Test

A substance found in the urine of pregnant women that can be measured to predict the development of preeclampsia is expected to lead to the development of a urinary test to screen high-risk women, according to a new findings appearing in the January 5, 2005, issue of the Journal of the American Medical Association (JAMA).

Researchers found that women were highly likely to develop preeclampsia if they had low levels of placental growth factor (PIGF) in their urine. PIGF works in combination with vascular endothelial growth factor (VEGF) to foster the growth of new blood vessels and maintain the health of cells lining the inside of blood vessels, including those in the placenta that support the developing fetus. The researchers believe that the high blood pressure and other symptoms characteristic of preeclampsia result from low levels of PIGF and VEGF and they are making plans to refine the finding into an accurate clinical test.

Although a few women are known to be at high risk for preeclampsia, the vast majority of cases strike without warning, in first-time mothers. In the study, researchers analyzed the stored urine samples of 120 women who developed preeclampsia and compared them to samples from 118 women who did not develop preeclampsia. Urinary samples of PIGF were significantly lower for the women who developed preeclampsia and grew more pronounced by the 20th through the 36th week of pregnancy.

The study builds on prior research, which discovered that a substance called soluble fms-like tyrosine kinase 1 (sFit-1) circulates in large quantities in the bloodstream of women with preeclampsia, and that high levels likely influence the development of preeclampsia by binding to PIGF and VEGF. To confirm preeclampsia is present in a woman, those with low levels of PIGF could be referred for a blood test to measure their blood levels of sFlt-1. However, a urinary test for PIGF could be performed less expensively.

Currently, first author Dr. Richard Levine, M.D., M.P.H., of the Epidemiology, Statistics, and Prevention Research Division of the U.S. National Institute of Child Health and Human Development (NICHD, Bethesda, MD, USA) is planning an additional study to more accurately predict the development of preeclampsia by measuring urinary levels of PIGF. He added that it also might be possible to develop a treatment for preeclampsia, by supplying at-risk women with additional PIGF and VEGF.

"We have reached a turning point in the extensive federal research investigation of this frequent, life-threatening complication of pregnancy,” remarked Duane Alexander, M.D., director of the NICHD. "This finding sets the stage for the development of a test to screen women for the high risk of preeclampsia.”




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S. National Institute of Child Health and Human Development