Preeclampsia affects 5-8% of pregnancies, approximately 300,000 women in the United States every year.
Although preeclampsia is potentially fatal, it is often asymptomatic. Preeclampsia is diagnosed and characterized by high blood pressure (hypertension), swelling from fluid retention (edema), and protein in the urine (proteinuria). Other common symptoms include headaches, dizziness, and blurred vision.
Preeclampsia can be diagnosed as early as the 20th week of pregnancy, but most commonly after the 32nd week of pregnancy.
The cause of preeclampsia is ultimately unknown. However, scientists have studied the mechanisms of preeclampsia in great detail. There is substantial evidence to suggest that certain biomarkers play a key role in the blood vessel dysfunction that leads to the life-threatening symptoms of preeclampsia.
When a woman becomes pregnant, she produces certain growth hormones, such as vascular endothelial growth factor (VEGF) and placental growth factor (PlGF); these are necessary for the mother to properly regulate her blood pressure and for the placenta to develop normally. However, preelcamptic women produce an excessive amount of growth factor receptors (sFlt-1, also known as soluble VEGF receptor-1) that are released into the blood circulation. The sFlt-1 receptors bind to the growth factors (VEGF and PlGF) while in circulation, and prevents them from binding to receptors on vital organs (e.g. kidney, liver, and brain). This triggers several adverse reactions in the pregnant woman, ultimately manifesting as preeclampsia.
Preeclampsia can be life-threatening to both the mother and the developing baby. Left untreated, preeclampsia could lead to several serious complications for the mother, including HELLP syndrome (kidney and liver failure), eclampsia (seizures), and death.
Treatment options for preeclampsia are limited, however preeclampsia management seeks to prolong pregnancy as much as possible. This is achieved by administering blood pressure medication if possible, and by constant monitoring of blood pressure and kidney function. Expectant management continues as long as the mother’s blood pressure remains stable, there are no signs of organ failure, and there is no fetal distress. If the condition worsens, the only option to save the life of the mother is to deliver the baby prematurely. At that point, the mother may receive anticonvulsants to prevent seizures and/or steroid therapy to help fetal lung development.
Premature delivery is a major cause of lifelong complications for the baby. The impact of premature delivery includes significant neurological damage, chronic lung disease, sensory defects such as deafness or blindness, cerebral palsy, epilepsy, and/or learning disorders. Preeclampsia may also lead to intrauterine growth restriction (IUGR) – a condition that results in malnourishment of the fetus, often with lifelong consequences.
Advanced Prenatal Therapeutics is developing a novel treatment for preeclampsia that seeks to prolong pregnancy so that the baby is born at term or as close to term as possible.
Apart from the human toll on patients and their families, the financial burden of preeclampsia is enormous. In 2005, the annual societal economic cost associated with premature birth was at least $26.2 billion. In 2003, it was estimated that neonatal hospital costs averaged $202,700 for a delivery at 25 weeks; costs decreased to $2,600 for a delivery at 36 weeks. Preeclampsia also impacts the workplace from loss of productivity as well as increased financial burden to employer-sponsored health insurance plans.