Summary: The Mirvie RNA platform has identified a unique molecular signature predictive of severe fetal growth restriction, potentially allowing early detection and intervention to reduce stillbirth risk.
Takeaways:
- Early Prediction of Growth Restriction: The Mirvie RNA platform accurately predicted 60% of severe fetal growth restriction cases months before delivery, surpassing current clinical risk assessment methods.
- Independent Molecular Signature: The study found that severe growth restriction has a distinct RNA signature unrelated to preeclampsia, hypertension, or gestational diabetes, offering a novel diagnostic approach.
- Potential for Personalized Prenatal Care: This breakthrough could lead to earlier interventions, including increased monitoring, genetic testing, and timely delivery planning, to improve pregnancy outcomes.
Mirvie, a provider aimed at bringing a personalized, predictive, and preventive approach to serious pregnancy complications, announced at the Society for Maternal-Fetal Medicine annual meeting that the Mirvie RNA platform has uncovered a unique molecular signature predictive for babies born with severe growth restriction.
Unrecognized fetal growth restriction is the single largest risk factor for stillbirth.
Drawing upon the largest molecular study of pregnancy completed to date, researchers examined more than 5,000 geographically and demographically diverse pregnancies, according to Mirvie.
“Similar to the breakthroughs that propelled the molecular understanding of breast cancer in the 1990s, obstetrics can now move towards a new standard of care based on the molecular characteristics of each pregnancy,” says Maneesh Jain, CEO and co-founder of Mirvie. “With the Mirvie RNA Platform, we can move toward a proactive and personalized care approach in maternal health that focuses on preventing serious pregnancy complications.”
Predicting Fetal Growth Restriction
Analyzing millions of maternal, fetal, and placental RNA messages using the Mirvie RNA platform, the technology was able to distinctly predict babies born with severe forms of growth restriction. Key findings include:
- Researchers successfully predicted 60% of babies with severe fetal growth restriction months in advance of delivery, a significant improvement over the current standard of care
- Current clinical risk factors used today, like advanced maternal age, maternal height, smoking status, and obesity are not predictive.
- The Mirvie RNA Platform found severe growth restriction has a unique RNA signature independent of preeclampsia, chronic hypertension, and gestational diabetes, all of which can impact fetal growth.
“There’s a large unmet need to better identify babies most at risk for stillbirth and other negative outcomes as indicated by poor growth because the majority are undiagnosed before birth,“ says Kara Rood, MD, a maternal-fetal medicine specialist and Clinical Associate Professor of Obstetrics and Gynecology at The Ohio State University Wexner Medical Center and principal investigator of the study who presented the findings. “Approximately 70% of babies with severe growth restriction – characterized as babies in the <third percentile for growth and at highest risk for stillbirth – are missed by a standard ultrasound. This leads to overtreatment and extra monitoring for those who don’t need it and insufficient monitoring and intervention for those who do. These novel findings powered by the Mirvie RNA platform are exciting and helping the field achieve this goal.”
Further Reading
Identifying High-Risk Pregnancies
Evidence-based interventions can be used by physicians and care teams if a pregnancy is identified as high-risk for severe fetal growth restriction, including:
- An etiology workup, deploying genetic testing like NIPT, amniocentesis, infectious testing and evaluating for structural anomalies
- Serial ultrasounds to monitor growth frequently during pregnancy
- Doppler studies can show if blood flow through the placenta and fetus is becoming impaired and decreasing over time
- Increased fetal monitoring
- Scheduled induction or C-section delivery depending on growth restriction and results from testing to prevent stillbirth testing
“At a molecular level, we now understand how biology impacts which pregnancies are at highest risk for poor outcomes,” says Thomas McElrath, MD, PhD, vice president of clinical development at Mirvie and a practicing maternal-fetal medicine physician at Brigham Women’s Hospital. “This breakthrough removes the bias and variability associated with clinical risk factors and assessments currently used to determine which babies may be at highest risk for fetal growth restriction. With a worsening maternal health crisis, we need innovative tools like Mirvie’s RNA platform to change the status quo and create better outcomes for mothers and babies.”
The novel findings add to the growing body of research demonstrating the use of the Mirvie RNA platform to predict pregnancy complications months before symptoms appear, including preeclampsia risk prediction in Nature and preterm birth risk prediction in the American Journal of Obstetrics and Gynecology.