The Food and Drug Administration for the first time approved a test to detect preeclampsia, a leading cause of maternal death in the US.
Preeclampsia, a potentially life-threatening form of high blood pressure that can develop during pregnancy or after childbirth, disproportionately harms Black women in the US. The disease is linked to the recent death of Tori Bowie, an Olympic sprinter who was found dead in her home last month due to complications from childbirth.
“Her story has been on the top of everyone’s mind,” said Dr Mike Aziz, a maternal fetal medicine specialist based in Pittsburgh. “The US maternal health crisis is a national embarrassment.”
The new preeclampsia test was widely celebrated as a small victory in the fight to make childbirth safer in the US. But doctors like Aziz warn that the new test is “not a panacea”, and is unlikely to protect the lives of women most vulnerable to preeclampsia.
“A lot of people are interested in quick fixes to the maternal mortality epidemic, but there is none,” Aziz said.
Developed by Thermo Fisher Scientific, the blood test helps predict if a patient will develop severe preeclampsia in the next two weeks. Doctors usually gauge a patient’s risk level by monitoring blood pressure and checking the proteins in urine, but the new test promises improved accuracy.
There is no cure or treatment for preeclampsia – the only way to help is by delivering the baby, which brings on the added risk of premature delivery.
Time is critical for preeclampsia care, so pregnant patients who present warning signs of the disease are often hospitalized and closely monitored. The new test will reduce the need for “lengthy hospitalizations” by allowing doctors to discharge low-risk patients, according to a study submitted to the FDA by Thermo Fisher.
“But you still have to regularly get your blood drawn every two weeks,” Aziz said.
He questioned the practical use of a test that assumes most pregnant patients can get to the doctor every two weeks, when a growing number of American women cannot access basic prenatal care.
Over one third of counties in the US do not have obstetric resources or birth centers, according to the March of Dimes, an organization that advocates for maternal and infant health.
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Aziz worries that innovations like the new Thermo Fisher test distract from the key drivers of the US maternal health crisis.
“There’s very little appetite for systemic changes that improve patients’ access to care, especially preventative care,” he said. “Systemic change doesn’t make a profit.”
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Even if a Black mother has consistent access to maternal care, some advocates worry that medical racism will hinder the benefits of the new testing option.
“This test seems like it’s going to be great, but then what is the OB going to do about the results?” said Chastity Mays, a certified doula in southern Illinois.
Mays coaches Black mothers through pregnancy and childbirth, often supplementing the care provided by an OB-GYN. She has seen her patients be sent home from the hospital or doctors’ office, despite presenting clear warning signs of pregnancy complications – including preeclampsia.
“So often, these moms are told, ‘oh you’re fine’ when they are clearly not,” Mays said.
Bowie’s death was a painful reminder that pregnancy and childbirth is deadlier for Black mothers, regardless of money or celebrity.
“We’re still dealing with the fact that our pain is not believed,” Mays said. “That’s a systemic issue in the current medical system, and it’s going to take more than one test to fix that.”
