‘Important implications for managing patients’ conditions during pregnancy’


SEATTLE (July 28, 2021) – A new scientific study led by Brotman Baty Institute members offers insights into pregnant women with preeclampsia and the association between the severity of the condition and high-circulating cell-free DNA.

The study, published today in the Journal of the American Heart Association, finds that increasing amounts of circulating cell-free DNA correlates with markers of preeclampsia, including earlier gestational age at delivery and worse systolic blood pressure.

“Understanding this correlation and being able to evaluate maternal tissue injury at the time of preeclampsia have important implications for managing patients’ conditions during pregnancy,” said Dr. Raj Shree the study’s corresponding author and assistant professor at UW Medicine’s Department of Obstetrics & Gynecology. “There also are implications for cardiovascular health later in life.”

Preeclampsia occurs in about 1 in 25 pregnancies in the United States, according to the U.S. Centers for Disease Control and Prevention. It is characterized by high blood pressure as well as damage to the liver, kidneys, or other organs, and frequently begins in the second half of a woman’s pregnancy. If left untreated, preeclampsia can be fatal to both the mother and unborn child.

In this study, Shree and other researchers from UW Medicine and the Fred Hutchinson Cancer Research Center examined plasma from pregnant women. They discovered the median cell-free DNA concentration was 10 times higher than that of a control group of plasma from women with uncomplicated pregnancies. When focusing on the preeclampsia cohort only, those participants with the highest total cell-free DNA levels also demonstrated a lower level of cell-free DNA derived from the placenta, suggesting that an abnormal placenta does not completely explain the findings.

In May of 2017, the University of Washington became the first U.S. academic institution to develop and clinically implement a cell-free DNA-based non-invasive prenatal screening platform using whole genome-sequencing and an in-house developed bioinformatics approach.

“While this study represents important findings in the field of preeclampsia research, further work is needed,” Shree said. “We need to determine the maternal sources of the increased cell-free DNA in preeclampsia and how both placental – and maternal – derived cell-free DNA contribute to the physiologic processes of this globally important disease. Such greater understanding will then lead to the development of more effective clinical interventions.”

The study, “At preeclampsia diagnosis, total cell-free DNA concentration is elevated and correlates with disease severity,” was funded by the National Institutes of Health and a pilot grant from BBI.

In addition to Shree, the other authors are:

  • Dr. Teodora R. Kolarava, UW Medicine Department of Obstetrics and Gynecology
  • Dr. J. Lee Nelson, Fred Hutchinson Cancer Research Center, professor in the Clinical Research Division
  • Dr. Hilary S. Gammill, UW Medicine Department of Obstetrics and Gynecology
  • Dr. Christina M. Lockwood, UW Medicine Department of Laboratory Medicine

The complete paper may be accessed here.