Nature Communications Study 2025

Paradigm-shifting study published in Nature Communications shows simple blood test can identify 91% of pregnancies that will develop preterm preeclampsia months before symptoms.

Researchers used data from more than 9,000 pregnancies within the multi-center Mirvie-sponsored Miracle of Life prospective study to discover and validate RNA signatures capable of distinguishing between severe and mild hypertensive disorders of pregnancy, including preeclampsia, months before symptoms occur. The study validated the test in women aged 35+ without pre-existing high-risk conditions.

Nature Communications Original Research Graph

Study reveals that preeclampsia is associated with at least two distinct molecular subtypes. The results demonstrate the condition stems from diverse underlying molecular pathways, converging into a similar presentation. Preeclampsia has historically been considered a single condition, defined by its symptoms and clinical presentation. This allows, for the first time, a personalized medical approach to pregnancy and prenatal care.

Clinical validation of the placental molecular subtype demonstrates high performance, achieving 91% sensitivity with an AUC of 0.88 in predicting preterm preeclampsia in advanced maternal-age pregnancies.

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FINDINGS:

Validated RNA signatures that distinguish between severe and mild hypertensive disorders of pregnancy, including preeclampsia, months before clinical presentation.

Strongly supports the hypothesis that preeclampsia is a condition with multiple underlying causes that lead to a common set of symptoms.

Demonstrates there is no molecular difference between preeclampsia in late pregnancy and gestational hypertension.

Risk stratification based on individualized RNA signatures offers a 15x improvement compared to using only maternal clinical and demographic characteristics.

Validation results indicate that a simple blood test can identify 91% of pregnancies that will develop preterm preeclampsia months ahead of symptoms, in women aged 35+ who do not have pre-existing high-risk conditions.

Those with a low-risk result have 99.7% probability of not developing preterm preeclampsia.

“Current guidelines are not helping us identify which patients are truly at high risk and we need better tools. Mirvie’s preeclampsia risk prediction test can now improve risk assessment, helping women and their care teams be informed and take actions with the potential to delay onset or prevent the disease.”

— Dr. Kara Rood

A maternal-fetal medicine physician, one of the principal investigators of the study, and Clinical Associate Professor of Obstetrics and Gynecology at The Ohio State University Wexner Medical Center.

CLINICAL SIGNIFICANCE:

Largest molecular study of its kind in pregnancy advances the biological understanding of hypertensive disorders of pregnancy, accelerating the potential for personalized care in obstetrics:

Despite the deployment of current guidelines from U.S. Preventive Services Taskforce and the American College of Obstetrics and Gynecology that rely on maternal clinical and demographic characteristics to identify pregnant women as at increased risk for preeclampsia, rates of the disease have nearly doubled in the last decade and now affect 1 in 12 pregnancies.

Mirvie’s test uses circulating RNA signatures to resolve this ambiguity, helping pregnant patients and their providers focus on the 1 in 4 pregnancies that are at high risk, ensuring optimal care for the right patients.

Given that the adherence to known prophylactic interventions for pregnancies at high-risk of preeclampsia such as daily aspirin is less than 50%, even among high-risk patients, understanding risk at an individual level will promote and reinforce compliance with prophylaxis.