Finding out I was pregnant was a joyous day, especially as an expectant mom living with Type 1 diabetes. While I understood the risks of carrying a child to term with that pre-existing condition, I was not knowledgeable about the serious pregnancy complication called preeclampsia until my endocrinologist, whom I worked with closely throughout my pregnancy, discussed her concern for me during a visit.
For years, doctors adopted a “wait and see” approach when diagnosing preeclampsia, with elevated blood pressure and protein in the urine as indicators. The challenge with this antiquated approach is that once symptoms develop, the condition can progress swiftly, necessitating prompt action. “Preeclampsia can lead to seizure, stroke, organ failure, hemorrhage, and even death to both the mother and her baby before, during, or after birth,” says Dr. Dallas Reed, MD, FACMG, FACOG, a practicing OB-GYN and geneticist. “Survivors also face a 4x increased risk of heart failure and a 2x increased risk of coronary heart disease, stroke, and death because of cardiovascular disease across their lifetime.”
Many factors influence how preeclampsia is managed, including the gestational age and health of the baby, the overall health and age of the mother, and a thorough assessment of the disease’s progression. To achieve this, doctors monitor blood pressure and evaluate laboratory test results that reflect the condition of the mother’s kidneys, liver, or her blood’s ability to clot. Other tests assess how well the fetus is growing and whether they appear to be in danger. If the pregnancy is less than 37 weeks, the doctor typically aims to prolong the pregnancy; however, if it is 37 weeks or later, the provider will often choose to deliver the baby.
Thankfully, there is now a first-of-its-kind innovation available to expectant mothers that predicts the risk for preeclampsia months before symptoms occur. The Encompass blood test, developed by Mirvie, provides a tailored action plan that includes a responsive virtual assistant and individualized support to give expectant women and their providers the tools to reduce preeclampsia risks. “Over the past decade, Mirvie has combined technological innovation with rigorous clinical evidence to deliver biological-data-driven approaches that usher in the era of predictive and preventive prenatal care,” said Maneesh Jain, CEO and Co-Founder of Mirvie, in a press release last month. “We’re thrilled that we can now help families with our work.”
The Encompass test for preeclampsia analyzes cell-free RNA measurements to evaluate placental health and the biology of the developing pregnancy to predict if the pregnancy is at risk for preeclampsia. While developing Encompass, Mirvie examined the molecular health of nearly 11,000 pregnancies across the U.S., and the test classified as “high risk” 90 percent of pregnancies that later developed preterm preeclampsia.
“Encompass is a paradigm shift based on an increased understanding of the underlying biology of pregnancy,” Dr. Thomas McElrath, Vice President of Clinical Development at Mirvie and a practicing maternal-fetal medicine physician at Brigham and Women’s Hospital, said in the press release. “Pregnant women with a high-risk result can have conversations with their care teams about interventions to mitigate risk, including additional monitoring, aspirin adherence, monitoring blood pressure at home, and more.”
The Encompass Test was launched across the U.S. with a direct-to-consumer purchase process. Working with physician offices, the e-commerce experience helps pregnant women age 35 or older (at time of delivery) buy the test from encompasstest.com. A licensed telehealth provider will review and approve the order, collect a blood sample through an at-home visit between 18-22 weeks of gestational age, and the results will be returned within 10-14 days to the mom and her provider care team, along with a preventive action plan.
And Encompass is just the latest breakthrough in the fight against the effects of preeclampsi. In 2023, researchers from Brown and Western Universities were able to identify the protein, cis P-tau, called a “crucial culprit and biomarker” for the preeclampsia. As it turns out, cis P-tau is also associated with neurological diseases, including Alzheimer’s disease and stroke. Potential new treatments for preeclampsia are also on the horizon.
While the Encompass Test is 18 years too late for me, it is welcome news in the fight for better prenatal care for millions of expectant women, especially women of color who are at higher risk for severe complications.
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