Chasing a blood test to prevent stillbirth

As a pregnancy advances past 38 weeks gestation, the risk of stillbirth slowly rises. This risk is even higher if the fetus has impaired growth due to placental insufficiency. Better detection of fetal growth restriction at term could prevent many cases of stillbirth and identify those that would benefit from planned timing of birth.

We know that the traditional methods of identifying small babies using a tape measure and physical examination of the woman’s abdomen misses two out of three growth restricted babies. Ultrasound is not the easy solution either, as it misses just over half of small babies as well. A new approach is urgently needed.

FLAG AND BUMPS – our biobank of blood samples to hunt for new biomarkers of stillbirth

A hunt for biomarkers in pregnancy cannot happen without a large cohort of samples with well-defined clinical outcomes.

Over eight years, Mercy Perinatal research midwives have collected blood samples from over 5,000 altruistic women, all of whom have generously donated their samples for research. This is our FLAG and BUMPs cohorts – a valuable biobank for us to look for biomarkers of poor placental function and stillbirth.

FLAG and BUMPs cohort is one of the world’s largest collections of blood samples from women at 36 weeks gestation. 

SPINT1 – a promising blood biomarker of stillbirth

Using the FLAG and BUMPs cohort, our scientific team have done an exhaustive search for new blood biomarkers for poor placental function.

We made a breakthrough discovery of a new biomarker of placental health, SPINT1.

SPINT1 levels in the blood are low when placental function is poor and when there is severe fetal growth restriction. Levels are high if the placenta is in good health.

Importantly, measuring SPINT1 at 36 weeks well outperforms current clinical care in identifying fetuses that are growth restricted. It has a double to triple detection rate of identifying fetuses that are <3^rd centile weight and at 10-15-fold increased risk of stillbirth.

We are excited by our discovery – it remains the best lead for any single protein biomarker for placental health. We have also now generated a third-generation assay that’s highly accurate in measuring SPINT1.

Mercy Perinatal is also leading the TIM TAMs study, a nationwide project that looks to use SPINT1 as a biomarker of placental health across Australia. We are partnering with friends from remote Broome (where 50% of those seeking pregnancy care are First Nations) to Gold Coast, Newcastle to regional Albury / Wodonga and metropolitan Melbourne.

We are hopeful SPINT1 might be used in the clinic as the first test of placental health, improving diagnostic precision, improving care and saving babies.

Deploying sophisticated technologies to hunt for other biomarkers of poor placental function

Aside from SPINT1, we are using sophisticated technologies to hunt for even better biomarkers of poor placental function. We are using ‘omic’ technologies and advanced platforms that can screen thousands of proteins, lipids and metabolites in the blood to fast-track our search for the best biomarker of poor placental function.