New Test May Be Able To Assess the Risk for Preeclampsia As Early as the First Trimester

If you are pregnant or expecting, you have likely heard of preeclampsia, a condition affecting 2%-8% of pregnant individuals. Preeclampsia is characterized by elevated blood pressure and protein in the urine. The condition usually develops after 20 weeks of pregnancy. Although preeclampsia can usually be managed, it can sometimes develop into full eclampsia or HELLP syndrome. At times, preeclampsia can be life-threatening, to both parents and their babies.

But there’s some hope out there, in the form of a new blood test from Labcorp that can assess the risk of preeclampsia in the early weeks of pregnancy before most people show symptoms.

“This test was designed to help identify people that have an increased risk of developing preeclampsia prior to 34 weeks gestation,” says April Bleich, MD, chair of obstetrics & gynecology at Burnett School of Medicine at TCU. “It can be performed in early pregnancy, from 11-14 weeks.”

This is a brand-new test and hasn’t yet been recommended by medical organizations such as the American College of Obstetricians and Gynecologists (ACOG). Still, there’s some optimism this test will be able to play a role in preventing and managing preeclampsia.

“We do not yet have enough information or data to support recommending that all pregnant women take this test,” says Dr. Bleich. “It is certainly promising and with further research, we may be able to incorporate it into clinical practice.”

Here's what you need to know about this new test, how it may impact people at high risk of preeclampsia, as well as expert advice about how to prevent and manage preeclampsia in general.

About the New Preeclampsia Test

This new test was developed by Labcorp, and it tests for signs of preeclampsia in your blood. The test is meant to be used in early pregnancy, between 11 and 14 weeks, and can tell you your risk of developing preeclampsia by 34 weeks of pregnancy.

According to a press release from the company, this test is the first of its kind to detect signs of preeclampsia in early pregnancy. Labcorp also launched other tests for preeclampsia earlier this year. These tests check for signs of severe preeclampsia during the last two trimesters of pregnancy.

“This screening test works by assessing the risk of preeclampsia prior to 34 weeks of gestation by evaluating four biomarkers associated with [the] risk of this condition,” explains Anushka Chelliah, MD, board-certified MFM specialist and medical director at Pediatrix Medical Group in Houston, Texas.

Biomarkers are molecules found in blood or body tissues that are possible signs of disease. The two blood biomarkers this test looks for are:

• Placental growth factor (PIGF hormone)
• Pregnancy-associated plasma protein-A ( PAPP-A)

Taken together with a blood pressure measurement of the average arterial pressure and the uterine artery pulsatility index (measured via ultrasound), these measurements can offer healthcare providers valuable information about your risk for preeclampsia, says Dr. Chelliah.

“Having low levels of PlGF and PAPP-A may suggest poor development and function of the placenta and high arterial pressure, and uterine artery pulsatility index is suggestive of hypertension and compromised blood flow in the uterine artery,” Dr. Chelliah notes.

Who Should Get This Test?

You might be wondering: should I get this test? First, keep in mind that guidelines for how to use this test haven’t been put out yet by major medical organizations. “

It is important to know that at this time, the availability of this test has not changed the clinical guidance for the management and diagnosis of preeclampsia through the American College of Obstetricians and Gynecologists (ACOG) or The Society for Maternal-Fetal Medicine (SMFM),” Dr. Chelliah says.

At this point, whether to take this test will be done on a case-by-case basis. This test can be used for any pregnant individual to assess their risk of preeclampsia in early pregnancy, Dr. Chelliah says. “It may be better suited for certain patients based on their past medical or obstetric history, and patients should discuss with their obstetrician or health care providers whether this test is a good option for them.”

Healthcare providers will use their clinical judgment to determine which pregnant individuals are at risk or who have potential signs of preeclampsia, says Abdulla Al-Khan, MD, vice chair and division director, Department of Obstetrics, Gynecology & Women’s Health at Hackensack University Medical Center.

While the test may be helpful for some, Dr. Al-Khan says, not everyone needs to take this test. “I would caution the over-utilization of this test since the study has only looked at 1000 patients,” Dr. Al-Khan points out.  

Dr. Al-Khan also notes that this is a screening test, not a test used to diagnose preeclampsia.

“A low value does not necessarily mean that the patient at [the] present time has pre-eclampsia that may necessitate delivery,” he says. “The test should not make a determination and or diagnosis of preeclampsia.  It should only tell you that the patient is at potential risk of developing it.”

How Will This Test Impact People at High Risk of Preeclampsia?

There are several risk factors that can increase the chances that you will develop preeclampsia during pregnancy. Risk factors include:

• Having high blood pressure
• Having diabetes
• Having kidney disease
• Having a BMI indicative of obesity
• Being of short stature
• Having nutritional deficiencies
• Having had high blood pressure in previous pregnancies
• Having a history of autoimmune disorders

“For those at high risk of preeclampsia, this test may provide further information related to the risk of development of the condition,” Dr. Chelliah says.

And how might it help these individuals?

“It may allow for a targeted clinical approach during the pregnancy with close surveillance with your provider, ambulatory blood pressure monitoring, and heightened awareness of symptoms and management when the risk of preeclampsia is further increased,” she describes.

How to Manage and Prevent Preeclampsia

The good news is that most cases of preeclampsia can be managed. For mild preeclampsia, this may include bed rest and close monitoring of pregnant individuals and their babies. More severe cases may require anticonvulsive medication and hospitalization for closer monitoring. Sometimes people with severe preeclampsia need to deliver their babies early.

The not-so-good news is that, as of now, there aren’t many options for preventing preeclampsia.

“At the present time, preeclampsia is unfortunately unavoidable,” says Dr. Al-Khan. However, there may be some ways to decrease the risk slightly, he notes. Both the ACOG and the United States Preventive Services Task Force recommend the use of low-dose aspirin (81 mg per day) after 12 weeks of pregnancy as a preventative measure in people at risk of preeclampsia.

Other possible ways to prevent preeclampsia include healthy eating during pregnancy, Dr. Al-Khan says, which may include reducing salt in your diet. You can also ask your provider about supplements such as  omega-3 fatty acid, calcium, antioxidant therapy, zinc, and magnesium, though there is limited evidence these are helpful, Dr. Al-Khan explains.

Exercise may be helpful too, says Dr. Bleich. “The best way to reduce your risk of preeclampsia and many other pregnancy complications is by staying active,” she describes. “There is good evidence that regular exercise reduces the risk of hypertensive disorders of pregnancy, including preeclampsia.” Studies show that aerobic activity for 30 to 60 minutes during pregnancy results in a significantly reduced risk.

Most importantly, stay in close touch with your doctor or midwife, Dr. Al-Khan suggests, and reach out if you have any concerns about any possible symptoms of preeclampsia during your pregnancy.

“Patients should be proactive and address any issues or concerns to their physicians in a timely fashion such as headaches, visual disturbances, chest pain, shortness of breath, non-dependent edema, elevated blood, pressure, and visual disturbances,” says Dr. Al-Khan.

If you are pregnant and thinking about your risk of preeclampsia, please reach out to your healthcare provider to discuss your concerns and to find out if this new test may be a possible assessment tool to be used for your care.