Earlier is better: a new way has been found to identify the pathology of a child in the womb

A new method for diagnosing the risk of fetal growth retardation and neurological abnormalities has been developed by Russian scientists from the V.I. Kulakov Research Institute of Obstetrics and Gynecology. This is an analysis of specific elements — neurotrophins and proteins, which are secreted by the child's brain. The technology will allow you to adjust pregnancy management or prepare the intensive care unit for childbirth. The technique is a significant and timely breakthrough in the field of perinatal diagnostics, the experts emphasized. How the new study will work is described in the Izvestia article.

How will fetal developmental delays be detected?

Russian scientists have developed a new method of perinatal diagnosis that allows predicting the risk of fetal growth retardation and potential neurological complications in a child based on a mother's blood test. This was reported to Izvestia by the National Medical Research Center of Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov.

The new method is based on the analysis of specific elements — neurotrophins and SUMO proteins, which are secreted by the brain of an unborn child. Changes in these proteins are associated with the risk of hemorrhages in the newborn's brain and subsequent problems, such as developmental delay. The study covered 820 mother-child pairs, and the sensitivity of the technology reaches 80%.

OCD occurs in 3-30% of pregnant women and can lead to serious complications. Scientists can predict the risk of intraventricular hemorrhages and other brain damage in a newborn and predict long-term consequences.

Early fetal delay occurs early in pregnancy and is associated with profound impairments in brain development. Late-onset OCD manifests itself closer to childbirth and leads to cognitive and motor problems in the child after birth. Children with delayed fetal development have two to three times the risk of neurological disorders by the first year of life. They are more likely to experience delayed psychomotor development, muscular dystonia, and various visual impairments, such as hypermetropia.

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The new analysis will reveal the risks already in the second trimester of pregnancy. To perform it, it is enough to take blood from a pregnant woman. The method uses different algorithms to diagnose risks for early and late forms of OCD, and also complements the standard procedures that are performed for all women in labor: ultrasound and Dopplerometry (ultrasound, which is used to assess blood flow in blood vessels).

The authors of the development are a group of Russian researchers with the participation of Natalia Kan, Director of the Institute of Obstetrics at the V.I. Kulakov National Research Medical Center.

"Previously, we saw the consequences of delayed fetal development only after childbirth," Natalia Kahn said. "Now we can intervene in advance, for example, to adjust pregnancy management or prepare an intensive care unit. This is a game changer in perinatal medicine. The new diagnostic method allows you to diagnose up to 35 diseases that can be treated after the birth of a baby, but our technology detects them in advance.

In the next five years, the method may become part of mandatory screening for at-risk groups: women with hypertension, pregnant smokers, and patients with a burdened obstetric history.

Why do I need diagnostics?

Neurotrophins are proteins responsible for the growth and survival of nerve cells, explained Irina Kolesnikova, an expert doctor at the Hemotest laboratory, a geneticist. And SUMO proteins regulate the work of other proteins, protecting neurons from damage.

"Changes in the levels of these substances signal the risk of hypoxia, that is, oxygen starvation, brain development disorders and possible hemorrhages in a newborn," she explained. — OCD is common in pregnant women and can lead not only to neurological disorders, but also to an increased risk of cerebral palsy and cognitive disorders. And also to complications in childbirth.

According to the expert, the new method combines high accuracy with safety and opens the era of a personalized approach to managing pregnancies with a risk of complications.

The development presented by Russian scientists is a significant and timely breakthrough in the field of perinatal diagnostics, said Kirill Masliev, Candidate of Medical Sciences, Head of the Department of Preventive Medicine at Rudn University.

"Especially in conditions when in Russia, as in most developed countries, there is an increase in the number of newborns with various developmental disorders, including signs of intrauterine growth retardation and potential neurological complications," he stressed. — From the point of view of clinical practice, the possibility of identifying the risk of OCD and related pathologies in the second trimester of pregnancy is a real revolution.

Until now, according to him, doctors have dealt only with the consequences: developmental delays were diagnosed mainly by ultrasound at a late stage or after the fact, when the child was born with severe disabilities.

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"If the new approach allows us to see the threat in advance and, importantly, with the help of a non—invasive and easily implemented procedure, a mother's blood test, then this is certainly a very important development and reaching a new level," said the expert. "The significance of such a prognosis goes beyond one specific pathology. We are talking about disorders affecting the formation of the brain, vascular network, and neurotransmitter systems.

This, in turn, is directly related to long—term consequences, ranging from muscular dystonia and delayed psychomotor development to possibly a wider range of conditions such as autism spectrum disorders (ASD).

— Although there is no direct causal relationship between ASD and ASD, more and more evidence suggests that, among other things, disorders of the intrauterine blood supply to the brain and a delay in its development can become triggers for the subsequent appearance of neurodevelopmental abnormalities, - Kirill Masliev explained. — Not just genetic or other factors.

Vadim Tkachenko, President of ANO Inpatient Replacement Technologies, noted that there are now a huge number of methods of perinatal diagnostics.

—Any method should be studied not only from the point of view of healthcare and the procedure for providing assistance, but also from a financial point of view, if this diagnosis is planned to be implemented," he said.

What impact will the new method have on parents?

The new method will be an excellent help for obstetricians and gynecologists in their work, said Sabina Khanmirzoeva, obstetrician-gynecologist at JSC "Medicine" (clinic of Academician Grigory Roitberg). Early detection of pathology allows you to solve the problem earlier.

"This is especially true in cases such as the risks of an undeveloped pregnancy, which are precisely related to the loss of time to identify pathology, miscarriages, and habitual miscarriage with two or more spontaneous abortions," she noted.

The discovery of Russian scientists is also a breakthrough in psychology, said Olga Kushnareva, an obstetrician-gynecologist, sexologist, and psychologist. The opportunity to identify the risk of intrauterine growth retardation and neurological disorders in the second trimester gives parents a chance to prepare and "change the course of events before the birth of a child."

"As a psychologist who works with such families, I can say that even a slight degree of delay is not just a diagnosis, it is a test that affects the whole family," the expert explained. — It is often in such situations that relationships collapse: women take on the brunt of care, men leave, unable to cope with reality. At the same time, the child remains in the most vulnerable position, and the entire support system falls on the shoulders of the mother, teachers, and early development specialists.

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The main problem is that parents are often not ready for this either emotionally, financially, or organizationally. They face a diagnosis after giving birth, when there are much fewer opportunities to change something.

"That is why the method that allows you to see a potential threat in advance gives you a chance to adjust pregnancy management, include additional examinations, and, if necessary, arrange follow—up at the perinatal center," she added. — It is also important that we are not talking about abstract indicators, but about clear biomarkers obtained from a routine blood test. This means accessibility and ease of implementation.

In addition, proper work with families at the diagnostic stage is of key importance.

— Now we are able to take care of even deeply premature and heavy children, to fight for everyone. But if we can prevent severe neurological consequences, it will be a qualitatively different level," Olga Kushnareva pointed out. — This means that not just more children will be born, but more healthy children.

According to experts, this is the basis for the formation of a more sustainable and prosperous generation.