Protein in urine may warn of preeclampsia risk in pregnant women

Preeclampsia, or toxemia, develops during pregnancy. In severe cases, it can rapidly escalate to eclampsia, a condition in which the mother suffers a series of potentially fatal complications.

Ananth Karumanchi, MD, a nephrologist in the Department of Medicine at BIDMC and assistant professor of medicine, obstetrics and gynecology at Harvard Medical School, explains that while in a healthy pregnancy, the mother’s blood vessels widen to nourish the fetus, the blood vessels narrow in preeclamptic women. “Our discovery suggested this was happening because the anti-angiogenic protein sFlt1 was attaching to and absorbing two pro-angiogenic proteins, PIGF and VEGF.”

Last year, a study conducted by Karumanchi and others confirmed that sFlt1 levels do indeed rise – while PIGF levels fall – prior to the onset of preeclampsia during pregnancy.

The investigators focused on the PIGF molecule, testing whether urinary PIGF levels would drop prior to the development of hypertension and proteinuria during pregnancy and could, therefore, predict which women would go on to develop preeclampsia.

Using urine specimens, Karumanchi, and Richard Levine, MD, MPH of the NICHD, compared the PIGF levels of women with normal pregnancies with those of women who went on to develop preeclampsia.

The results demonstrated that urinary PIGF levels were dramatically lower in the preeclamptic patients.