- Researchers say a simple blood test has shown promise in detecting biomarkers for pregnancy complications such as preeclampsia and gestational diabetes.
- They say this early detection can result in earlier treatments, which can lead to better health outcomes.
- Experts say more study is needed, but these types of blood tests could make pregnancy safer for mothers and infants.
Blood tests could potentially provide early warning signs for preeclampsia, gestational diabetes, and intrahepatic cholestasis during pregnancy, according to a study conducted at Ningbo University in China.
In their research published today, the scientists looked for possible biomarkers in 112 women who were pregnant.
The participants were divided into four groups – one group for each condition and one group of women with healthy pregnancies.
The researchers indicated in a press release that the three conditions are potentially dangerous and early identification and treatment could help prevent poor outcomes and lifelong consequences.
The causes of these conditions still need to be fully understood.
The researchers initially took medical histories and blood samples for each person.
They looked for a connection to the gut microbiome by analyzing seven short-chain fatty acids, including acetate, propionate, butyrate, isobutyrate, isovalerate, valerate, and hexanoic acid.
Short-chain fatty acids are metabolites produced in the large intestine through the fermentation of indigestible fiber and starches, according to researchers.
The findings from the study include the following:
- All women in the groups with pregnancy complications had elevated levels of isobutyrate acid.
- Women with gestational diabetes and preeclampsia had elevated levels of isovalerate, acetate, and propionate.
- Those with intrahepatic cholestasis had lower levels of all the short-chain fatty acids except isobutyrate acid.
Based on the results, the researchers concluded that short-chain fatty acids were closely related to the three pregnancy complications and can be used as potential markers to identify the conditions through blood tests.
Some doctors say that after additional research, this screening test could help treat pregnant women.
“If this comes to fruition and we can identify a high-risk group earlier than current screenings allow, we can start treatment earlier, potentially improving outcomes,” Dr. Monte Swarup, an OB/GYN in Chandler, Arizona, and founder of HPD Rx, told Healthline. “This is promising very early research, but we need more research for clinical utility,”
Not everyone agrees, however.
“Using short-chain fatty acids as a predictor of gestational diabetes, cholestasis, and preeclampsia is an interesting idea,” Dr. G. Thomas Ruiz, the OB/GYN lead at MemorialCare Orange Coast Medical Center in California, told Healthline. “But is this test better than the screens we are currently using? Is it going to change how to manage these high-risk conditions? My initial thought was that short-chain fatty acids are not helpful.”
“Elevated short-chain fatty acids can be any of three disorders, all of which we manage differently,” Ruiz added. “I don’t see how this testing would be useful as it is not specific enough. I would like to see tests specific to each disorder.”
The three pregnancy complications looked at by the researchers were:
- Gestational diabetes
- Intrahepatic cholestasis
These are potentially dangerous conditions – for the mother and the baby.
“Preeclampsia and intrahepatic cholestasis of pregnancy are sources of adverse maternal and/or fetal outcomes such as fetal death in some instances,” said Dr. Michael Cackovic, a maternal-fetal medicine physician at The Ohio State University Wexner Medical Center.
“We already know that certain patient populations are at risk for these diseases and clinical management would be individualized as such,” Cackovic told Healthline. “For example, first-time moms are at increased risk for preeclampsia so they would be followed closer.”
He added that women who have a parent with diabetes have a higher risk of gestational diabetes, so they should be screened earlier in pregnancy.
In the United States, the condition affects between 2 and 10% of pregnancies. It results from the body not making enough insulin. It doesn’t typically have symptoms and obstetricians generally test for it between the 24th and 28th week of pregnancy.
When you have gestational diabetes, you have a higher risk of:
- Having a baby over 9 pounds, potentially making delivery more difficult
- Delivering your baby prematurely, which can lead to breathing and other health issues
- Having a baby with low blood sugar
In addition, your baby is more at risk of developing type 2 diabetes later in life.
Following a healthy eating plan, staying active, and checking your blood sugar can help prevent any problems caused by gestational diabetes.
“There is a screening test now for gestational diabetes – it is a one-hour glucose challenge test,” said Dr. Kecia Gaither, an OB/GYN and specialist in maternal-fetal medicine as well as the director of Perinatal Services/Maternal Fetal Medicine at NYC Health + Hospitals/Lincoln in the Bronx.
“If that is abnormal, a three-hour glucose tolerance test is given. If this is abnormal, we can diagnose with gestational diabetes,” she told Healthline.
Preeclampsia is a condition that develops during pregnancy, according to the American Pregnancy Association.
It can result in high blood pressure and elevated protein levels in the urine, which might indicate problems with your kidneys or other organs.
While high blood pressure during pregnancy does not mean you have preeclampsia, it can be the first sign of the condition.
Some of the other symptoms of preeclampsia include:
- Blurred vision
- Difficulty with bright light
- Nausea or vomiting
- Urinating small amounts
- Pain in the upper right abdomen
- Shortness of breath
- Easily bruising
The mother could develop eclampsia, a more severe form of the condition that includes seizures, problems with blood clotting, and decreased liver function.
Obstetricians may recommend delivering early if the condition develops close to the delivery due date.
“Delivery is a cure for preeclampsia and is used to prevent maternal adverse outcomes like stroke, but, as you can imagine, delivery is not always in the best interests of the baby if it would occur at an early gestational age like 24 weeks,” Cackovic said.
If delivery is not an option, your doctor could recommend rest, decreased salt intake, increased checkups, drinking at least eight glasses of water per day, and adding extra protein to your diet
Screening consists of checking blood pressure at each prenatal doctor visit.
“There is currently no screening test for preeclampsia. It is diagnosed via clinical symptoms and lab abnormalities or fetal findings, such as growth restriction or lack of amniotic fluid,” Gaither told Healthline.
Intrahepatic cholestasis is a common liver condition that develops during pregnancy, according to a
Digestive fluids produced in the liver go into the small intestine to help digest food. During intrahepatic cholestasis, the bile builds up in the liver and can enter the bloodstream.
One of the symptoms is itchy skin. It occurs during the second or third trimester and can result in the following:
- Respiratory distress syndrome
- Meconium passage
- Fetal asphyxiation
Symptoms typically end after delivery. Early delivery might be necessary because of the risk of death to the infant. There are some medications, such as
One of the warning signs is itchy palms and the soles of the feet.
“This is currently diagnosed via clinical signs with abnormal bile acids and liver enzymes. There is no specific screening test,” Gaither said.
While the study results are promising, “A great deal of additional information is needed as this is preliminary research,” Swarup said.
“These tests need to be studied in larger populations prospectively before any clinical utility. There is a long way to go, but this is how great ideas might start,” he noted.
Besides safety, experts say there are practical matters that need to be addressed before the screening is considered viable.
“Characteristics such as reasonable cost, safe to administer, ability to detect a high proportion of disease preclinically and if there are interventions available to improve a positive result are necessary in defining a good screening test,” Cackovic pointed out.
“For example, can we suppress preeclampsia if we determine a patient will become preeclamptic later in pregnancy? As of now, the answer is no but perhaps in the future an early test for susceptibility will have a clinical use to achieve this result,” he added.