MultiCare collaborates on study to make pregnancy safer

Pregnancy is often a time of excitement and anticipation, yet it can also be a time of worry, particularly if complications arise.

Health problems such as gestational diabetes, preeclampsia and premature (preterm) birth affect one in five pregnancies, according to the biotech company Mirvie.

Many pregnancy complications go undiagnosed until symptoms appear, often in the third trimester (28-40 weeks) or when a mother gives birth. A diagnosis in this time frame can make a condition more challenging to effectively manage.

But one simple blood test could hold the key to improving pregnancy care.

The MultiCare Institute for Research & Innovation is collaborating with Mirvie on a research study to develop a screening test that can predict a mother’s risk of pregnancy complications. Esther Park-Hwang, MD, is principal investigator of the study.

“If we could use a blood test to diagnose early in pregnancy the likelihood of pregnancy complications, such as preterm birth, and make a difference in how we manage the care of women with preeclampsia and other serious conditions, it would make a huge impact on the health of mothers and their babies,” says Dr. Park-Hwang, an OB-GYN at MultiCare Tacoma General Hospital and associate clinical professor at the University of Washington.

Harnessing the power of biomarkers

Throughout her more than 25-year career at MultiCare, Dr. Park-Hwang has cared for many women with high-risk pregnancies. Board-certified in obesity medicine, she helps patients with obesity lose weight prior to conceiving — which can reduce the risk of developing pregnancy complications — supports them in getting pregnant and also guides them through pregnancy.

“This study aligns with my professional interests, and it’s also very unique,” Dr. Park-Hwang says. “One of the hottest areas of research right now is predictive biomarkers, and while there’s been biomarker studies on cancer detection and prognosis, no one has examined predictive biomarkers in the context of pregnancy.”

Biomarkers are characteristics, or traits, that can indicate what’s happening in the body. For example, blood pressure and weight are both biomarkers. Other biomarkers are detected through tests on bodily fluids or tissues. Biomarkers can:

• Reveal disease prognosis (the course a disease will likely take)
• Predict a person’s response to cancer treatment
• Predict the likelihood of developing a certain disease

In this observational study, the research team is investigating biomarkers in the blood of women between 18 to 22 weeks pregnant. Participants donate a small of amount of blood, and the research team examines medical records from their pregnancies after they give birth.

The team’s goal is to determine if links exist between pregnancy complications and biomarkers in the blood. If complications could be detected months ahead of time by measuring specific biomarkers, it could help address disparities in maternal and infant health.

Preeclampsia — a leading cause of maternal mortality in the United States — disproportionately affects Black, American Indian and Alaska Native women. Rates of preterm births are approximately 50 percent higher among non-Hispanic Black women than white women, and the earlier a baby is born, the higher the risk of death or disability.

“What this study — and the development of the predictive screening test — have the power to do is give us a much wider window to identify, address and potentially prevent specific pregnancy-related complications,” Dr. Park-Hwang says. “Early detection followed by patient education, treatment, vigilant monitoring or intervention can help improve outcomes for mothers and babies.”

Improving pregnancy care for the next generation

People participate in clinical research for many reasons, but a driving factor for many who joined this study was a desire to help others.

“A lot of women were motivated to participate because they had gone through pregnancy complications themselves at some point,” says Meagan Krueger, a clinical research coordinator at the Research Institute who manages operations and recruitment for the study. “Many participants wanted to help other women have smoother pregnancies and deliveries in the future.”

One of those participants was Itzia Martinez, a medical assistant and mother of two.

“Before my second child was born, I had a miscarriage. It was unexpected and it was a really difficult experience for me and my husband,” says Martinez. “If I could potentially help other expectant moms by donating blood, then I was more than willing to do that.”

The study has enrolled over 8,000 participants in the U.S. so far, with a goal of 10,000. While it’s still enrolling at other sites across the country, the Research Institute stopped accepting new participants in March 2023.

“What this study — and the development of the predictive screening test — have the power to do is give us a much wider window to identify, address and potentially prevent specific pregnancy-related complications.”

The final results of the study will not be available for a year or more, but the preliminary results are promising:

• Data published in the journal Nature found that the platform Mirvie uses to analyze blood samples effectively identified 75 percent of pregnant women who went on to develop preeclampsia.
• Data published in the American Journal of Obstetrics and Gynecology indicates the platform predicted 76 percent of preterm birth cases.

To learn more about leading-edge research, visit the MultiCare Institute for Research and Innovation. You can also search the Research Institute’s current list of open clinical trials and studies.