- The Washington Times - Friday, January 7, 2005

A substance in a pregnant woman’s urine can be measured to predict the later development of a serious condition called preeclampsia in the mother-to-be, research shows.

“We may have reached a turning point in the extensive federal research investigation of this frequent life-threatening complication of pregnancy” with this report, said Dr. Duane Alexander, director of the National Institute of Child Health and Human Development, which is part of the National Institutes of Health.

Preeclampsia is a condition marked by dangerously high blood pressure and the excretion of protein into the urine.

Symptoms include sudden weight gain, headaches, swelling and vision changes; however, some women with rapidly advancing disease report few symptoms.

The study found women were “highly likely” to develop preeclampsia if they had low levels of a substance known as placental growth factor, or PlGF, in their urine.

PlGF works in concert with a substance called vascular endothelial growth factor (VEGF) to foster the growth of new blood vessels and to protect the cells that line the insides of blood vessels, including those in the placenta that support the developing fetus.

“The rate of preeclampsia in first pregnancies is two to three times higher than in subsequent pregnancies. It can occur in as much as 8 percent of first pregnancies,” said Dr. Richard Levine, lead author of the study, published in this week’s issue of the Journal of the American Medical Association.

According to the Preeclampsia Foundation, the condition and other hypertensive disorders of pregnancy are a leading global cause of maternal and infant illness and death. By conservative estimates, these disorders are responsible for 76,000 deaths each year.

“About a third of cases of preeclampsia are severe,” said Dr. Levine of NICHD’s Division of Epidemiology, Statistics, and Prevention Research.

In some cases, he said, preeclampsia may progress to eclampsia, a series of potentially fatal seizures. Although the hypertension and seizures can be treated, hundreds of women die of the condition yearly. The only cure for preeclampsia is the birth of the child.

But babies born to mothers with preeclampsia are often small for their gestational age or are born prematurely. Those conditions place the infants at risk for other complications, such as blindness, cerebral palsy and mental retardation.

Scientists involved in the research say high blood pressure and other symptoms associated with preeclampsia result from low levels of both PlGF and VEGF. But until now, monitoring was limited to blood samples.

For the study, scientists analyzed stored urine samples of 120 pregnant women who developed preeclampsia and compared them with samples from 118 pregnant women who did not develop the condition. Levels of PlGF were significantly lower in the urine of pregnant women who went on to develop preeclampsia than they were for the 118 women who did not contract the disorder.

Dr. Levine said the paper in JAMA is “important,” because it shows that preeclampsia can be monitored “in the urine as well as the blood,” and this sets the stage for easier screening including, eventually, an at-home testing kit.



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