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Scientists develop first test to predict onset of preeclampsia in pregnant women

Publication date: Jan 12, 2007 12:03:04 PM

A group of research scientists led by an academic from UCL (University College London) has developed a diagnostic test which can predict the onset of preeclampsia (PE), the primary cause of maternal deaths during pregnancy.

A paper published in the current issue of Hypertension outlines the enormous potential of a simple urine test, which monitors the incidence of an antigen called inositol phosphoglygan P-type.

The presence of this antigen is shown to be an indicator of overt PE, with the research demonstrating that it was absent in normal pregnancy. In some subjects, it was possible to detect an increase of the antigen in urine up to seven weeks before a clinical diagnosis would traditionally be possible.

The researchers also believe that inositol phosphoglygan P-type may potentially be the toxic element which causes the condition. This element is known as ‘factor x’, and is seen by researchers in the field of reproductive medicine as vital to the understanding and treatment of preeclampsia.

Preeclampsia affects approximately five per cent of pregnant women worldwide. It can occur any time during pregnancy but normal manifests in the third trimester. This amounts to over 7 million pregnancies a year, leading to 22,000 maternal deaths, as well as causing many babies to be born prematurely. More rarely, it can develop into eclampsia, which affects 700,000 pregnancies a year, leading to 43,000 maternal deaths worldwide.

In the early stages, there are no symptoms. Symptoms of more serious problems may develop as preeclampsia progresses. These include high blood pressure, headaches, blurred or altered vision, abdominal or shoulder pain, nausea and vomiting, confusion, shortness of breath and excessive swelling of the hands and feet. Preeclampsia can quickly develop into a life threatening condition for both mother and foetus.

Professor Thomas W Rademacher, from UCL’s Division of Infection and Immunity, who led the research, said:

“Being able to predict the onset of this disease has been the single greatest challenge in obstetric medicine. Preeclampsia is the most common of the serious complications that can occur during pregnancy and affects millions of women and children. It is a particular problem in the developing world, where treatment is less readily available.

“Our research has identified that the presence of inositol phosphoglycan P-type is a reliable indicator of whether a pregnant woman will develop PE.

“This means that by way of a simple urine test during pregnancy, we can identify which women are most at risk of developing the condition. Clinicians could therefore adapt the care of those most at risk accordingly. Now a reliable diagnostic test has been developed, this paves the way for identifying new treatments for the condition.

“PE is presently only curable by delivery. This means that in many cases clinicians must deliver a baby in order to save its mother’s life, even if this means the baby is born prematurely. For clinicians, it is a precarious balance between acting to save the mother and needing to get the baby to as fuller term as possible, so the risks to its health are reduced.”

PE arises when the placenta releases a toxin causing the mother's blood pressure to rise sharply. If the condition develops into eclampsia it can cause seizures and the mother may lapse into a coma.

Currently, clinicians measure the blood pressure of pregnant women and levels of protein in the urine in order to try and anticipate PE, but they are not wholly reliable as predictors of the condition.

Preeclampsia was identified over 150 years ago, but its prime cause remains unknown. It was thought for many years to be more common in first pregnancies. However, one strand of more recent research has demonstrated that the length of time a couple have been together could also be a crucial factor. The theory suggests that women who have acclimatised to their partner’s sperm for a longer period of time are less at risk of developing the condition.

-Ends-

Notes for Editors

1. For more information, please contact Professor Thomas W Rademacher, Tel: +44 (0)20 7679 9373, Mobile: +44(0)7711 612 912, Email: t.rademacher@ucl.ac.uk

2. Alternatively, please contact Ruth Metcalfe, UCL Media Relations, Tel: +44 (0) 20 7679 9739, Mobile: +44 (0)7990 675 947, out of hours: +44 (0)7917 271 364, Email: r.metcalfe@ucl.ac.uk

3. The paper ‘Inositol Phosphoglycan P-Type in Preeclampsia. A Novel Marker?’ was published in Hypertension on Wednesday 20 December 2006. Journalists can obtain copies of the paper by contacting the UCL Media Relations Office.

4. The study was carried out at UCL and at John Radcliffe Hospital, Oxford.

About UCL

Founded in 1826, UCL was the first English university established after Oxford and Cambridge, the first to admit students regardless of race, class, religion or gender, and the first to provide systematic teaching of law, architecture and medicine. In the government’s most recent Research Assessment Exercise, 59 UCL departments achieved top ratings of 5* and 5, indicating research quality of international excellence.

UCL is the fourth-ranked UK university in the 2006 league table of the top 500 world universities produced by the Shanghai Jiao Tong University. UCL alumni include Mahatma Gandhi (Laws 1889, Indian political and spiritual leader); Jonathan Dimbleby (Philosophy 1969, writer and television presenter); Junichiro Koizumi (Economics 1969, Prime Minister of Japan); Lord Woolf (Laws 1954, Lord Chief Justice of England & Wales); Alexander Graham Bell (Phonetics 1860s, inventor of the telephone), and members of the band Coldplay.