A comprehensive study supported by the National Institutes of Health (NIH) has revealed that protein analyses conducted during the first trimester of pregnancy do not enhance predictions for identifying individuals at risk for hypertensive disorders of pregnancy. Despite the urgent need to predict and manage these conditions, the study, which is the largest of its kind, found no added benefit from screening proteins from early pregnancy blood samples.
Study Details
The study involved 1,850 participants who were first-time mothers between 2010 and 2013. Researchers analyzed 6,481 proteins from blood samples taken during the participants’ first trimester. Follow-up assessments occurred during the second and third trimesters, post-delivery, and two to seven years after pregnancy.
The focus was on whether these proteins or their combinations with clinical data (e.g., maternal age and cardiovascular disease risks) could predict the occurrence of hypertensive disorders of pregnancy. Conditions assessed included:
Gestational Hypertension: High blood pressure developing after 20 weeks of pregnancy.
Preeclampsia: Significant blood pressure rise after 20 weeks, potentially damaging organs and marked by elevated protein levels in the urine.
Findings
Despite the extensive protein analysis, the prediction models did not significantly improve risk assessments for hypertensive pregnancy disorders. The models’ predictive ability did not surpass existing clinical criteria, which include risk factors such as obesity, diabetes, high blood pressure, or advanced maternal age.
One notable finding was that higher levels of the protein quiescin sulfhydryl oxidase1 (QSOX1), indicative of cellular growth, in early pregnancy correlated with a two-fold reduction in the likelihood of experiencing a hypertensive disorder of pregnancy. Contrastingly, previous studies have linked elevated QSOX1 levels in late pregnancy to increased risks, suggesting the need for further research into the pathways related to hypertensive disorders of pregnancy.
Implications
Hypertensive disorders of pregnancy affect 10-15% of individuals and are linked to increased risks of pregnancy complications, heart attacks, strokes, and, in severe cases, death. Although the study’s findings do not support the use of early pregnancy protein analysis for risk prediction, they underscore the necessity for alternative approaches to better identify those at risk.
