A landmark Burnet Institute study to identify women at risk of pre-eclampsia in low- and middle-income countries will go ahead with the support of a grant from the Gates Foundation valued at USD$499,930.
A life-threatening complication of pregnancy, pre-eclampsia can be prevented simply and effectively with low-dose aspirin — but women first need to be identified as being high risk.
“New tools use algorithms to predict a woman’s risk of developing pre-eclampsia, and they are relatively accurate,” Dr Annie McDougall, senior research fellow with Burnet’s Global Women’s and Newborn’s health group, said.
“But these tools were developed in high-income countries, predominantly in white populations, and have not accounted for risk factors common in West or sub-Saharan Africa, such as sickle cell disease, which is known to put women at a higher risk of pre-eclampsia.
The project will incorporate the biggest aspirin trial ever conducted in low- and middle-income countries with more than 200,000 women expected to be screened.
The research team will leverage data from PEARLS — the world’s largest study on aspirin use to prevent pe-eclampsia — to build an improved algorithm for these populations into a digital tool to be used and tested in these settings.
PEARLS is investigating the efficacy and safety of different doses of aspirin to prevent pre-eclampsia in a multi-country trial underway in Ghana, South Africa, Kenya and India.
“In high-income countries, you get very few women who will die from pre-eclampsia because of the higher level of monitoring, so it’s picked up more rapidly, and the cure is initiated by delivering the baby,” Dr McDougall said.
“As well, babies delivered very early are more likely to survive in high-income settings where we have higher-functioning ICUs and support facilities.
“But that’s not the case in sub-Saharan Africa and India where many more women have the risk factors, and where the highest number of women are dying from preeclampsia.”
