“Preeclampsia has been considered a footnote in pregnancies far too long.”
These words, declared by Eleni Tsigas, Executive Director of the Preeclampsia Foundation
in America, launched the 2012 Preeclampsia Research Symposium in Toronto on November 14, 2012, which was organized by Dr. Lee Adamson, Senior Investigator with Mount Sinai’s Samuel Lunenfeld Research Institute. Tsigas’ personal story placed a patient’s perspective on a day that brings scientists from around the world together to discuss the latest breakthroughs in perinatal research.
Preeclampsia is an increasingly important problem in the health of pregnant women and their children due to a number of reasons, including trends in increasing ages of women experiencing pregnancy and an increased incidence of obesity. Tsigas’ own struggle with preeclampsia, which led to the stillborn death of her daughter at 29 weeks, highlights an area of women’s and infant’s health care that clinicians need to make sure their patients are aware of.
“Our ultimate goal is to find a cure for preeclampsia,” says Dr. Adamson, who is also the founding Director of the Luneneld’s Research Centre for Women’s and Infants’ Health BioBank
, which collects donated placentas and umbilical cord blood for research. “Bringing together these researchers is so important because we can now pool our knowledge to accelerate improved pregnancy outcomes and long-term health of both mothers and babies.”
Preeclampsia occurs in about five per cent of pregnancies and may develop from 20 weeks’ gestation, often leading to pre-term delivery or poor fetal growth. Apart from Caesarean section or induction of labour, there is no known cure and previous drug approaches have been unsuccessful. It is the most common and dangerous pregnancy-related complication that affects both mother and unborn child.
Lunenfeld scientists who presented key findings from their current preeclampsia research were Drs. John Kingdom and Isabella Caniggia.
Last year, in the first study of its kind, Dr. Kingdom and his team of researchers discovered a new mechanism for a common blood thinning drug to prevent severe high blood pressure in pregnancy, and the ensuing, potentially fatal effects on a developing baby. The study was published in the leading medical journal Obstetrics and Gynecology.
“In women with a previous history of severe pre-eclampsia, heparin significantly reduces the risk of recurrent disease,” says Dr. Kingdom. “Heparin is a complex molecule—we can remove the anticoagulant properties of the drug to make it potentially safer, and thus in the future attempt to reverse pre-eclampsia by giving higher doses of ‘optimized heparin’ that could restore better vascular function and lower blood pressure.”
Dr. Kingdom added that a clearer understanding of how heparin works in pregnancy opens new avenues for more effective, safer use of the drug in other areas of obstetrics. Dr. Kingdom is also head of the Placenta Clinic
at Mount Sinai Hospital, which provides multidisciplinary care to women and their partners/families with previous, current, or anticipated placental complications of pregnancy.
Dr. Isabella Caniggia is a leading authority on placental development and preeclampsia. Her lab has identified the genetic alterations that predict if pregnant women will have early or late onset preeclampsia. The earlier preeclampsia is detected, the better the chances for improved health of both mother and child.
Dr. Caniggia’s research has led to several patents on potential diagnostic tools and clinical practices. Recently, several of Dr. Caniggia’s biomarker findings were licensed to help develop a new diagnostic tool that will detect and manage preeclampsia in expectant mothers over the next five years. Potentially, physicians will use a point-of-care kit to detect and measure increased levels of the biomarker endoglin in expectant mothers who are at increased risk of preeclampsia.
Dr. Stephen Lye, Associate Director of the Lunenfeld, also spoke at the symposium about the importance of clinical data from birth cohorts and specimens from the BioBank resource at Mount Sinai, which together are vital for discovering causes and cures for preeclampsia.