PREGNANCY: A test to predict the risk of complications earlier

Pregnancy complications are generally associated with an inability of the mother’s body to adapt to the multiple transformations induced by pregnancy. Almost every organ system in the mother’s body must change function during pregnancy in order for the baby to thrive. When the mother’s body doesn’t adjust properly to the growth of the baby, it can have serious consequences, including stunted growth or overgrowth in the baby, gestational diabetes and pre-eclampsia or high blood pressure, which can kill the baby. These complications can lead to more difficult deliveries, sometimes requiring surgery and putting the baby at risk of lifelong health problems.

Check the adaptation of the mother’s body to pregnancy using the placental secretome

Here, the Cambridge team focuses on the placental secretome, or any molecule secreted by the placenta, and identifies biomarkers present from the first trimester of pregnancy, opening up the possibility of early detection of the risk of complications including a diagnosis that normally would only during the 2 3rd trimester. However, at this stage, these complications can already have serious consequences for the health of both mother and child. In addition, current diagnostic methods are not sufficiently sensitive or reliable to identify all high-risk pregnancies.

Test the levels of certain hormones in the placenta makes it possible, according to this work, to predict which women are at risk of complications from their pregnancy. “The female body is remarkable, and from conception onwards, a pregnant woman’s body must adapt almost all of its organ systems in order for the fetus to develop. The fetus also needs nutrients and oxygen to grow, so the mother must adjust her metabolism and vascular system to provide them to her baby. Our study shows that placental hormonal biomarkers can predict potential complications. After all, these biomarkers are detectable from the first trimester of pregnancy.”summarizes the lead author, Dr. Amanda N. Sferruzzi-Perri, Fellow of St. John’s College, Cambridge University.

The placenta, a field of biological evaluation: The placenta forms and grows from the fertilized egg and attaches to the wall of the uterus. The placenta serves as the lungs, kidneys, intestines, and liver for growing babies, carrying oxygen and nutrients to the fetus while secreting hormones and excreting waste products. Although its role is vital, the placenta remains difficult to examine in pregnant women.

The team developed new methods to isolate and study endocrine cells from the placenta of mice, as these cells are responsible for secreting hormones during pregnancy. They profiled the placenta to identify secreted hormones and create a comprehensive map of these placental proteins. This mouse placental hormone protein map was then matched to datasets from studies of human placenta and pregnancy outcomes, and the researchers identified several biological overlaps:

  • about a third of the proteins we have identified are altered in women during pregnancy with the condition;
  • from the first trimester of pregnancy, from the 12th week, abnormal hormone levels can be detected in the mother’s blood. This is especially true for women who have developed gestational diabetes, a complication of pregnancy generally diagnosed between 24 and 28 weeks;
  • Several specific transcription factors, proteins that can turn genes on or off and regulate hormone production by the placenta, have important implications for pregnancy outcomes;
  • By analyzing blood samples from pregnant women, the researchers show that these biomarkers are present early in pregnancy,

suggesting the possibility of much earlier diagnostic testing for complications.

Specifically, this new test could detect gestational diabetes earlier in pregnancy, which in some cases could prevent the disease or protect mothers and babies from more harmful complications.

At the clinical level, this work will help further strengthen pregnancy safety and improve clinical care by targeting the placenta.

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