Unraveling the Deadly Enigma of Pre-eclampsia Maternal Deaths
Pre-eclampsia continues to be a deadly enigma, causing over 70,000 maternal deaths annually worldwide. Despite its prevalence, the cause of this severe pregnancy complication remains largely unknown to scientists.
After an illustrious athletic career that earned her seven Olympic gold medals, Allyson Felix never imagined the challenges of pregnancy would rival her toughest races. Felix had taken great care of her body for years, yet her experience with pre-eclampsia showed her the unpredictability of this dangerous condition.
During a routine check-up at 32 weeks, Felix learned she had severe pre-eclampsia and was rushed to the hospital. The following day, doctors performed an emergency C-section. Her daughter, Camryn, was born prematurely and required weeks in intensive care. While Camryn is now a healthy five-year-old, the experience revealed the dangers of pre-eclampsia — dangers that claimed the life of Felix’s teammate, Tori Bowie, in April 2023.
The Complexity of Pre-eclampsia
Pre-eclampsia is responsible for more than 70,000 maternal deaths and 500,000 fetal deaths each year, occurring suddenly at any stage of pregnancy. Researchers believe excessive inflammation originating in the uterus interferes with critical communications between mother and fetus. This disruption leads to abnormal placental development and heightened blood pressure, endangering both mother and child.
Current knowledge points to autoimmune disorders, age, and a high BMI as potential risk factors. There is also evidence that rates of pre-eclampsia are up to 60% higher in Black women. Experts, like Dr. Garima Sharma, suggest that structural inequalities in healthcare access may contribute to these elevated risks, but it remains unclear why pre-eclampsia affects certain women.
Predicting Pre-eclampsia
Researchers are striving to identify predictive biomarkers for early pre-eclampsia detection. One promising protein, soluble fms-like tyrosine kinase 1 (sFlt-1), is being studied as a potential diagnostic marker. Elevated levels of sFlt-1 indicate inflammation in the uterus, which could help doctors predict pre-eclampsia and intervene before symptoms worsen.
The diagnostic approach developed by Thermo Fisher Scientific aims to predict whether hypertensive pregnant women will develop pre-eclampsia within two weeks. Although this tool can help prevent severe symptoms, it is crucial to continue developing ways to detect pre-eclampsia earlier in pregnancy.
Innovative Approaches to Pre-eclampsia
New research includes “placenta-on-a-chip” technology, led by Associate Professor Lana McClements, which mimics conditions in the placenta during pre-eclampsia. This model could lead to discovering new biomarkers and treatments.
Beyond early detection, medication repurposing is being considered for pre-eclampsia treatment. Drugs like metformin, commonly used for diabetes, show promise in delaying the onset of severe pre-eclampsia.
Additionally, researchers are testing CBP-4888, an experimental drug designed to reduce levels of sFlt-1. These efforts aim to prevent the condition before it becomes life-threatening.
Addressing Inequalities in Pre-eclampsia Outcomes
Dr. Allison August of Comanche Biopharma stresses the importance of focusing on populations most at risk. Women of color bear a disproportionate burden of pre-eclampsia, making it vital to conduct inclusive clinical trials in affected areas.
More investment in pre-eclampsia research is essential. Women’s health research still receives far less funding than other health areas. Yet, pre-eclampsia affects the long-term health of both mothers and their children, warranting the need for greater attention and resources.
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