Biomarker-Based POC Tests for Preeclampsia Could Transform Maternal Care in Low-Resource Settings
This systematic review evaluates blood and urine biomarkers for preeclampsia not only on clinical performance but critically on their suitability for point-of-care formats such as lateral flow assays compatible with low-resource settings. While most biomarker research has focused on complex multi-parameter laboratory assays for high-income countries, the authors argue that simple, affordable POC tests are most urgently needed where intensive care facilities for PE-related emergencies are limited. The review maps a path from proteomic and metabolomic discoveries to implementable rapid diagnostics.
The original study
Towards biomarker-based tests that can facilitate decisions about prevention and management of preeclampsia in low-resource settings.
- Authors
- Acestor N, Goett J, Lee A, Herrick TM, Engelbrecht SM, Harner-Jay CM, et al.
- Journal
- Clinical chemistry and laboratory medicine
- Type
- Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S., Systematic Review
- PMID
- 25992513
Original abstract
In recent years, an increasing amount of literature is emerging on candidate urine and blood-based biomarkers associated with incidence and severity of preeclampsia (PE) in pregnant women. While enthusiasm on the usefulness of several of these markers in predicting PE is evolving, essentially all work so far has focused on the needs of high-resource settings and high-income countries, resulting primarily in multi-parameter laboratory assays based on proteomic and metabolomics analysis techniques. These highly complex methods, however, require laboratory capabilities that are rarely available or affordable in low-resource settings (LRS). The importance of quantifying maternal and perinatal risks and identifying which pregnancies can be safely prolonged is also much greater in LRS, where intensive care facilities that can rapidly respond to PE-related health threats for women and infants are limited. For these reasons, simple, low cost, sensitive, and specific point-of-care (POC) tests are needed that can be performed by antenatal health care providers in LRS and that can facilitate decisions about detection and management of PE. Our study aims to provide a comprehensive systematic review of current and emerging blood and urine biomarkers for PE, not only on the basis of their clinical performance, but also of their suitability to be used in LRS-compatible test formats, such as lateral flow and other variants of POC rapid assays.