Next Steps to Prevent the Major Complications of Late Pregnancy
Preeclampsia, fetal growth restriction (undernourished baby) and spontaneous preterm birth are the major complications of late pregnancy. They are leading causes of illness and death in mothers and newborn babies. In the developed world, in almost half the cases either the mother and/or baby require admission to an intensive care unit. Every year, an estimated $41 billion is spent on healthcare costs related to these pregnancy diseases.
Preeclampsia is a severe high blood pressure condition where the mother can develop kidney or liver problems, stroke and seizures. It affects 5% of first time mothers. Each year, the number of maternal deaths from preeclampsia is equivalent to the loss of 170 jumbo jets of pregnant women. A quarter of the babies born to mothers with preeclampsia are growth restricted and a third are premature.
Fetal growth restriction is usually due to placental problems leading to inadequate nutrition of the baby and overall affects 1 in 10 pregnancies.
One of the greatest risks to a baby's health is premature birth. Premature babies are 10-times less likely to survive. Two-thirds of all premature births are caused by spontaneous premature labour.
All three conditions can have lifelong consequences for the child. The child may have problems with brain development that can result in mild learning difficulties through to severe disabilities. Being born growth restricted predisposes the child to high blood pressure, heart attacks and diabetes as an adult. The social consequences and lifelong economic costs resulting from these conditions are enormous. Prevention of these health problems is of paramount importance to future mothers, fathers and children.
Prenatal Care Today
Currently, there is no screening test that accurately predicts which first time mothers will develop these late pregnancy diseases. Prenatal care consists of a series of consultations during pregnancy with a doctor or midwife. One of the main reasons for these checks is to detect early signs of these pregnancy complications. Unfortunately, these problems often present suddenly. The standard intervals between prenatal visits may result in delays in diagnosis with an increased chance of severe complications. If at risk first time mothers were able to be identified in early pregnancy, known therapies could prevent almost a third of cases.
Predict to Prevent
Identification of first time mothers at risk for these conditions is the first step to effective intervention and prevention. Through SCOPE, we expect to develop an early pregnancy screening test that will offer first time mothers accurate risk assessment for each disease. The intensity of prenatal care could then be matched to each woman's personal risk profile and preventative therapies offered to those at high risk. The majority of women at very low risk could be reassured and medical intervention in their pregnancy care minimized.