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Cardiologist from the Medical Center - University of Freiburg presented an innovative approach to predicting pre-eclampsia at a major US congress on March 6 / Troponin test could help detect risk early and provide targeted support for women at risk

Around five percent of all women develop pre-eclampsia during pregnancy, which in severe cases can be life-threatening for mother and child and may require an emergency caesarean section. Until now, the risk has been determined rather unspecifically on the basis of factors such as diabetes, obesity or the mother's age. Prof. Dr. Dirk Westermann, Medical Director of the Department of Cardiology and Angiology at the Medical Center - University of Freiburg, presented a completely new approach at the American College of Cardiology (ACC) Congress in New Orleans, USA, on Sunday, March 6, 2023. The Freiburg cardiologist and his team showed that commercially available troponin tests could be used to identify high-risk patients much earlier and more accurately than before. Troponin tests have long been used in acute diagnostics for suspected heart attacks.

"We were able to show that the troponin level in the blood is very closely associated with the risk of subsequent pre-eclampsia. Severe cases in particular can presumably be predicted very well. This could enable early and targeted prevention in the future," says Westermann.

The numerous risk factors for pre-eclampsia include severe obesity, diabetes, previous multiple pregnancies and a very young or old mother. If several of these factors come together, the pregnant women are closely monitored and receive prophylactic medication with aspirin. However: "By no means all women with risk factors actually develop pre-eclampsia. We were able to show that women with a low troponin level did not develop pre-eclampsia despite having risk factors. Around 40 percent of the women would therefore not have needed closer care," says Westermann. For their study, the Freiburg physicians examined 3,080 blood samples from four international studies involving a total of 2,293 pregnant women.

"We can already treat women with pre-eclampsia very well today. However, the causes of the disease are still unknown, which makes diagnosis much more difficult. A reliable test that can indicate the development of pre-eclampsia at an early stage would be a great help," says Prof. Dr. Ingolf Juhasz-Böss, Medical Director of the Department of Obstetrics and Gynecology at the Medical Center - University of Freiburg.

In the next step, the researchers want to verify their results in a prospective study and combine the data from the troponin test with other risk factors. This could further increase the safety of pregnant women and their unborn children.