Urine Test Could Predict Preeclampsia in Pregnant Women, Study Finds

A new test that detects certain proteins in the urine of pregnant women could be used to predict which women will experience preeclampsia -- a potentially life-threatening pregnancy complication characterized by high blood pressure and other symptoms that affects 200,000 U.S. women each year, according to a study published in the Jan. 5 issue of the Journal of the American Medical Association, the Boston Globe reports (Dembner, Boston Globe, 1/5).

Dr. Richard Levine, a research medical officer at the National Institute of Child Health and Development, and colleagues compared urine samples taken from 238 pregnant women, 120 of whom later developed preeclampsia and 118 who did not. The researchers found that the women who went on to develop preeclampsia had low levels of placental growth factor in their urine between the 25th and 28th week of pregnancy, while women who did not develop preeclampsia did not, according to the Baltimore Sun. Discrepancies in levels of placental growth factor between the two groups of women became even more pronounced during weeks 29 through 36 of pregnancy, the Sun reports (Niedowski, Baltimore Sun, 1/5).

The study's findings might "pave the way" for a screening test to allow physicians to predict and treat preeclampsia -- which can occur without warning and cause seizures, stroke or hemorrhaging in the woman and premature delivery of the infant -- before it becomes life-threatening, Reuters reports (Reuters, 1/4). The cause of preeclampsia is unknown, and currently there is no test available to predict or detect the condition, which usually arises after the 20th week of pregnancy, according to the Newark Star-Ledger (Stewart, Newark Star-Ledger, 1/5).

However, the study's authors believe that, based on their results, a simple urine test might help physicians and women themselves predict who is most at risk for the condition, the AP/Long Island Newsday reports. "If there were a self-administered test developed, similar to a pregnancy kit, it could tell women if they're in trouble and to see their doctor right away," Levine said. The test could not prevent preeclampsia, but it could help physicians monitor women at risk and prescribe medications to reduce their risk, according to the AP/Newsday (Colias, AP/Long Island Newsday, 1/4).

Ananth Karumanchi, a Harvard University Medical School researcher and an author of the study, said, "A simple urine test could help predict the onset of this disease one to two months before the onset of clinical symptoms and that could make a tremendous difference in outcomes for patients, in particular those women who have limited access to specialized medical care" (Reuters, 1/4). Levine estimated it could take four or more years to develop such a screening test (AP/Long Island Newsday, 1/4).

Benjamin Sachs, chair of the obstetrics and gynecology department at Beth Israel Deaconess Medical Center in Boston -- which contributed to the study -- said, "This new study provides us with another important piece of evidence as we work toward developing the means to diagnose, and eventually to treat, this serious condition," London's Guardian reports. He added, "This is of especially critical importance in other regions of the world where preeclampsia poses a significant threat to the health of mothers and their infants" (Boseley, Guardian, 1/5).

"We may have reached a turning point in the extensive federal research investigation of this frequent, life-threatening complication of pregnancy," NICHD Director Duane Alexander said, adding, "Once these women are identified through [a urine screening] test, we can target studies to find effective ways to prevent its progression or to keep the most dangerous complications from occurring" (NIH release, 1/4).

However, others remained skeptical of the benefits of the study results and the possibility that a urine screening test could help women avoid the symptoms and negative outcomes associated with preeclampsia, the Wall Street Journal reports. "This probably won't have a significant impact," in part because a preeclampsia screening test will not cure the disorder or necessarily help doctors prevent symptoms, Stephen Emery, director of obstetrical ultrasound at the Cleveland Clinic, said, according to the Journal. He added that women not currently being screened for preeclampsia -- a routine exam for most women receiving adequate prenatal care -- also would not benefit from a future urine test, according to the Journal (Burton, Wall Street Journal, 1/5). Additional research and further studies are planned, Levine said (Kotulak, Chicago Tribune, 1/5). NBC's "Nightly News" on Tuesday reported on the study. The segment includes comments from Karumanchi (Bazell, "Nightly News," NBC, 1/4). The complete segment is available online in Windows Media.