Blood test shows promise for birth risk early detection

In Australia, up to 8% of all pregnancies will involve a complication that has the potential to harm the mother or baby, or both, if left untreated.
 
But there is hope on the horizon.
 
Researchers at the University of Queensland (UQ) have developed a new rapid sensor test that uses a blood sample to detect pregnancy complications – including gestational diabetes, preeclampsia, and preterm birth – as early as 11 weeks.
 
These complications are not usually determined until the second or third trimesters.
 
The study, published in Science Advances, saw blood samples collected from 201 pregnant women at 11–13 weeks gestation. Using the rapid sensor test, which works by screening blood samples for cell biomarkers, scientists were able to detect the possibility of a complication with 90% accuracy.
 
Lead author, Professor Carlos Salomon Gallo, told newsGP the team’s focus is on extracting as much information as possible about the health of the placenta, which often holds answers about how a pregnancy will unfold.
 
‘The placenta is essentially the organ that is the interface between the maternal circulation and the foetal circulation. In the majority of the complications of pregnancy … there is some placental dysfunction associated,’ he said.
 
‘What we developed is a biomarker panel that allows us to determine how healthy the placenta is.
 
‘Essentially, we measure biomarkers that are encapsulated in extracellular vesicles, released from the placenta into the maternal circulation.’
 
Dr Mostafa Kamal Masud, from UQ’s Australian Institute for Bioengineering and Nanotechnology, explained that extracellular vesicles carry critical signals between maternal and foetal cells during pregnancy.
 
‘This technology has been developed using nanomaterials to detect low concentrations of biomarkers, which are parts of our cells that show health complications we might be carrying,’ he said.
 
‘This is what makes our technology more sensitive than current testing methods and why it can pick up potential pregnancy complications much earlier.’
 
Dr Ka-Kiu Cheung, Chair of RACGP Specific Interests Antenatal and Postnatal Care, told newsGP while the place for new technologies, such as the rapid sensor test, in pregnancy care is still unknown, ‘anything that improves the outcomes for pregnant women and their families is welcomed’.
 
‘These new technologies speak to Professor [Kypros] Nicolaides’ inverted pyramid of prenatal care, where more intensive screening and interventions in the early stages of pregnancy can improve the risk of developing complications later on, including the need to deliver a baby early,’ she said.
 
‘Preterm birth costs $1.4 billion annually in Australia and has a significant impact on disability and death in under-five-year-olds. The repercussions for families and the community include ongoing health and educational supports required for children born early.’
 
Recent data shows about 30,000 babies born in Australia each year experience growth and developmental impairments due to pregnancy complications.
 
Gestational diabetes is one of the most common pregnancy complications, with almost one in five women (18%) who gave birth in an Australian hospital in 2021–22 diagnosed with the condition. While women who have risk factors may be tested earlier, it is usually diagnosed between 24-28 weeks gestation.
 
Preeclampsia, which happens in around 5–8% of Australian pregnancies, can be life-threatening for both mother and baby in severe cases, and is not usually diagnosed until after 20 weeks – and mostly during a routine prenatal visit in the third trimester.
 
While pre-term birth, which affected almost one in 10 babies (8.3%) in Australia in 2022, is a risk usually determined through cervical length screening between 16–24 weeks.
 
And with the new test is still in the early stages of its development, Dr Cheung says healthcare professionals already have recommendations for pre-eclampsia screening and implementing low-dose aspirin if the results are high-risk.
 
‘There is also vaginal progesterone for women at risk of pre-term birth through cervical length screening between 16–24 weeks,’ she said.
 
‘As evidenced by these interventions the role of the GP in caring for women in the first stages of pregnancy is vitally important.
 
‘Particularly when most hospitals don’t have the capacity to see women before 20 weeks of gestation.’
 
Professor Salomon Gallo says the technology has the potential to save the healthcare system millions annually, by reducing neonatal intensive care unit admissions and prevent emergency interventions, including caesarean sections.
 
To achieve this, he says the team’s aim is for the test to be as accessible as possible.
 
The next steps will involve developing a prototype of the point-of-care device, followed by a clinical trial involving at least 2000 women. If they are able to replicate their current findings, he says the test ‘should be available in 3–5 years’.
 
While the end goal is to develop a point-of-care test, validating a point-of-care device is a longer process, but the professor says there is also the option to run the test through a pathology lab.
 
‘That potentially could be quicker,’ he said.
 
‘Then women can just go to the GP to get a referral and go to the closest pathology lab to get tested.
 
‘But that will be our end goal, to develop this as a point-of-care device. The good thing about the bio sensor that we developed is, because it amplifies the signal, you don't need much blood to actually quantify the molecule. So, it will be very similar to, for example, when you can measure your glucose level.’
 
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