Doctoral defence: Ele Hanson “Clinical and biochemical markers for prediction and early diagnosis of pregnancy related complications”

On November 30th Ele Hanson will defend her thesis “Clinical and biochemical markers for prediction and early diagnosis of pregnancy related complications”.

Supervisors: 
Professor Kristiina Rull, University of Tartu
Professor Helle Karro, University of Tartu
Professor Maris Laan, University of Tartu

Opponent: 
Associate professor Meryam Sugulle, University of Oslo (Norway)

Summary:
Most of the pregnancies proceed without problems, however, complications occur approximately one in four pregnancies. 

Between 2012 to 2018 we conducted three studies in Women’s Clinic, Tartu University Hospital to assess risk factors and screening methods for preeclampsia (PE) and gestational diabetes (GDM).  

PE is pregnancy complication with new hypertension after 20 pregnancy weeks and additional maternal or fetal health problems. At least one of the risk factors referring to increased risk for PE (chronic hypertension, diabetes, kidney disease, previous PE, obesity, IVF, maternal age > 40 and nulliparity) occurred in 53% of pregnant population. Presence of a risk factor increased individuals’ risk for PE 7.8-fold, especially for women with pre-pregnancy diabetes and/or previous PE. However most women with risk factors will not develop PE.  

For early PE detection in the III trimester, two placenta derived markers (sFlt-1 and PlGF), were analyzed from blood samples of pregnant women. The test detected 58% of subsequent PE cases with false positive rate of 10%.  

The detection was improved by combining simultaneous measurement of biomarkers (sFlt-1, PlGF, ADAM 12, sEng, and leptin) and maternal characteristics (gestational age and maternal weight at the blood draw). This novel test detected 100% of subsequent PE cases with 4% of false positive rate.  

GDM, is one of the most common pregnancy complications and is diagnosed when hyperglycemia is detected during oral glycose tolerance test (OGTT) after 20 pregnancy weeks. 

In Estonia, referral to OGTT for GDM screening is recommended for women with risk-factors: overweight or obesity, family history of diabetes, previous GDM and/or birth of a large newborn, polycystic ovaries syndrome, fasting glucose >5.1 mmol/L, glycosuria, excessive weight gain or suspicion of macrosomic fetus. 

Our study showed increasing numbers of individuals with GDM risk factors, referrals to OGTT and GDM diagnosis within seven years. Pregnant women with GDM risk factors, despite of normal OGTT, were at risk of increased gestational weight gain and large for gestational age newborns.

You can also watch defence via Teams.