New perspectives on shaping the future of pregnancy health

The urgent need to innovate pregnancy health to a proactive, personalized and preventive future

There are a million different questions that any expecting mom will think of during her pregnancy. What can I eat? How much weight is safe to lift? What medications can I take? The list goes on and on. There are hundreds of books on pregnancy health, and the sheer number of do’s and don’ts can feel overwhelming to expecting parents. Fundamentally, what every mom wants to know is simple: what can I do to keep myself and my baby healthy?

Patient Perspective

This question is key because while most women go on to have healthy pregnancies, we know that 1 in 5 pregnancies are impacted by a complication.1 And often, moms had no warning that their pregnancy was any different until it was too late.

Until now, it hasn’t been possible to have a warning before pregnancy complications strike because the tools to effectively identify higher risk pregnancies have not been available. Since the 1930s, women have all been placed on the same standard pregnancy visit schedule, with remarkably little change since then.2 Meant to provide optimal care for all, some professionals have opined that care has unfortunately become one-size-fits-none.2 For this reason, it’s paramount that we continue to innovate our approach to pregnancy health. Although we’ve made significant progress with modern medicine, women and their infants still die each day due to pregnancy-related complications. It’s hard to believe that as recently as the early 20th century, pregnancy killed almost 1 in 100 U.S. women.3 Fortunately, the 20th century brought many crucial medical advances, such as more widespread availability of c-sections, blood transfusions, and antibiotics. But even today, 1 in 5000 moms are dying from pregnancy-related complications, and more than 1 in 10 babies are born premature in the United States.4,5

What can we do now to move beyond this unacceptable status quo? We know that the key advances in pregnancy health in the 20th century were primarily focused on reacting to problems more effectively rather than proactively anticipating and even preventing complications. Treating complications was a much-needed first step. Now, in the 21st century it is imperative for us to move past simply reacting to complications as they arise and to shift the focus to prevention.

The future of pregnancy health is personalized

Recent landmark research shows the Mirvie RNA platform can predict preeclampsia and early preterm birth months before symptoms occur.6-8 This groundbreaking approach can enable a new, more proactive future for pregnancy health. RNA messages found in the blood can provide an important window into how a pregnancy is progressing and can alert us when there is a higher risk of preeclampsia, preterm labor or other complications. For the first time, a simple blood test from mom will provide expecting parents with an understanding of the underlying biology of their individual pregnancy and risk of complications.

Not only will this empower parents, but it can also strengthen the partnership between expecting parents and their doctors and midwives so they can plan for the future together. Using these RNA-derived insights, they can create a personalized care plan: from education, visit schedules, monitoring, medications, lifestyle changes and appropriate follow-up testing, pregnancy care will be transformed from one-size-fits-none to right-sized care for every mom. Instead of feeling overwhelmed with the multitude of possible questions to focus on, from nutrition to exercise and beyond, moms will be given clarity on what is most important for their unique biology. And by examining the underlying biology of each unique pregnancy, we can ensure both mom and baby are truly as healthy as possible through care that is proactive, personalized, and ultimately, preventive.

1. Trends in pregnancy and childbirth complications in the U.S. Blue Cross Blue Shield. Published June 17, 2020. Accessed August 6, 2022.
2. Peahl AF, Howell JD. The evolution of prenatal care delivery guidelines in the United States. Am J Obstet Gynecol. 2021 Apr;224(4):339-347. doi: 10.1016/j.ajog.2020.12.016. Epub 2020 Dec 13. PMID: 33316276.
3. Maternal mortality in the United States: A primer. Issue Brief and Report. The Commonwealth Fund. December 16, 2020. Accessed August 6, 2022.
4. Hoyert DL. Maternal mortality rates in the United States, 2020. NCHS Health E-Stats. 2022. DOI: https://dx.doi.org/10.15620/cdc:113967.
5. Hamilton BE, Martin JA, Osterman MJK. Births: Provisional data for 2021. Vital Statistics Rapid Release; no 20. Hyattsville, MD: National Center for Health Statistics. May 2022. DOI: https://dx.doi.org/10.15620/cdc:116027
6. Ngo TTM, Moufarrej MN, Rasmussen MH, Camunas-Soler J, Pan W, Okamoto J, Neff NF, Liu K, Wong RJ, Downes K, Tibshirani R, Shaw GM, Skotte L, Stevenson DK, Biggio JR, Elovitz MA, Melbye M, Quake SR. Noninvasive blood tests for fetal development predict gestational age and preterm delivery. Science. 2018 Jun 8;360(6393):1133-1136. doi: 10.1126/science.aar3819. PMID: 29880692; PMCID: PMC7734383. https://www.science.org/doi/full/10.1126/science.aar3819
7. Rasmussen M, Reddy M, Nolan R, Camunas-Soler J, Khodursky A, Scheller NM, Cantonwine DE, Engelbrechtsen L, Mi JD, Dutta A, Brundage T, Siddiqui F, Thao M, Gee EPS, La J, Baruch-Gravett C, Santillan MK, Deb S, Ame SM, Ali SM, Adkins M, DePristo MA, Lee M, Namsaraev E, Gybel-Brask DJ, Skibsted L, Litch JA, Santillan DA, Sazawal S, Tribe RM, Roberts JM, Jain M, Høgdall E, Holzman C, Quake SR, Elovitz MA, McElrath TF. RNA profiles reveal signatures of future health and disease in pregnancy. Nature. 2022 Jan;601(7893):422-427. doi: 10.1038/s41586-021-04249-w. Epub 2022 Jan 5. PMID: 34987224; PMCID: PMC8770117. https://www.mirvie.com/nature-magazine-media-release-january-5-2022
8. Camunas-Soler J, Gee EPS, Reddy M, Mi JD, Thao M, Brundage T, Siddiqui F, Hezelgrave NL, Shennan AH, Namsaraev E, Haverty C, Jain M, Elovitz MA, Rasmussen M, Tribe RM. Predictive RNA profiles for early and very early spontaneous preterm birth. Am J Obstet Gynecol. 2022 Jul;227(1):72.e1-72.e16. doi: 10.1016/j.ajog.2022.04.002. Epub 2022 Apr 6. PMID: 35398029. https://www.mirvie.com/american-journal-of-obstetrics-gynecology
Read other articles by Alison Cowan, Head of Medical Affairs
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