Grant: Project Grant

Preeclampsia, a condition characterized by high blood pressure and multiple organ impairment, affects 5-8% of pregnancies and leads to serious complications for both mother and baby. Unfortunately, there is currently no useful clinical tool for its early prediction.The stages of preeclampsia initiate early in the first trimester, but clinical symptoms appear only in the second half of pregnancy. Thus, there is a window of opportunity to predict preeclampsia early in pregnancy. Previous tools that have been proposed have been shown to inadequately predict preeclampsia. On the other hand, it has been increasingly realized that malfunction of the mother's arteries is associated with progression towards preeclampsia. Indeed, we have previously shown in a small group of pregnant women that this malfunction may be detected, in the first trimester, as hardened arteries. The evaluation of arterial hardening can be performed safely and non-invasively, and is thus a promising tool for early preeclampsia prediction.The present study aims to determine in a larger population whether the assessment of arterial hardening can be used to predict preeclampsia. To do so, we will recruit pregnant women at high risk for preeclampsia from 8 obstetrical centers across North America and Europe. We will measure the hardening of the arteries in the first trimester and compare its predictive performance for preeclampsia to that of known clinical risk factors as well as alternative tools (e.g. blood tests, ultrasound). We will also perform the same assessments in the second trimester to determine whether preeclampsia risk prediction could be improved. Effective prediction of preeclampsia would identify pregnant women who would benefit most from preventive measures in a timely manner. Moreover, it will allow for the concentration of limited health care resources towards those women who are truly at high-risk, and help in the long-term to accelerate the development of new preventive treatments.