Moving Pregnancy Health Toward Proactive and Preventive Care

Maneesh Jain leads Mirvie’s efforts to develop the first test to predict pregnancy complications by revealing the underlying biology of pregnancy health. As a proven life-science entrepreneur, Maneesh has served in founding, executive, and board roles at transformational biotech startups addressing large unmet needs for more than two decades. He has helped pioneer the first platforms to create more accessible next generation sequencing (Ion Torrent) and medical ultrasound imaging (Butterfly Network), as well as the first liquid biopsy plasma test for the early detection of cancer (Cirina and Grail).

Close to 4 million patients give birth each year in the US, and prenatal care is considered one of the most common health services in the nation. Despite widespread innovation across health care, clinicians still lack modern tools and technology to provide preventive and personalized care to moms and expecting parents—and they deserve better.

Today, one in five women is impacted by pregnancy complications like preeclampsia, preterm birth, and gestational diabetes, which can often result in threatening consequences for both moms and babies. In today’s standard of care, which relies on generalized risk assessments based on factors such as pregnancy history, race, BMI, ethnicity, and medical history, only 20 percent of pregnancy complications can be predicted. That means 80 percent of potential complications are missed when using these types of assessments. At the same time, maternal mortality in the US is climbing, with recent reports from the CDC noting the mortality rate  jumped from 20.1 per 100,000 live births in 2019 to 23.8 in 2020.

Perhaps the biggest contributor to this issue is that pregnancy health care has historically been understudied and underfunded—in fact, our current prenatal care model has remained largely the same since 1930. Not only is pregnancy health care lacking in modernization, but there are also significant barriers to prenatal care for younger people, people of color, low-income individuals, linguistic minorities, and other marginalized groups in the US According to the Kaiser Family Foundation, Black and American Indian/Alaskan Native women have pregnancy-related mortality rates three and two times higher, respectively, than their White counterparts. All women are at risk of pregnancy complications, regardless of their background, and complications often result in lifelong consequences for both mom and baby. Women, especially those from underserved communities, face these consequences due in part to an already broken health care system.

COVID-19 reshaped much of the health care landscape as we know it, emphasizing consumer demand for equitable access to care and igniting individuals to pursue a deeper understanding of their personal health. The pandemic has also shed light on the gaps present in our health care systems, including those present within pregnancy health, but we know change is possible.

Predictive technologies have advanced in recent years in sectors such as oncology, with early detection of cancer possible through liquid biopsy, and there is nothing stopping the pregnancy health care field from leveraging this type of technology. Specifically, by leveraging RNA in a similar way to what powers COVID-19 vaccines—we can reveal a fundamental understanding of the underlying biology of each unique pregnancy, including pregnancy complications, by analyzing the tens of thousands of RNA messages from the baby, the placenta, and the mom, which drive dramatic changes in pregnancy. By doing so, we can unlock the type of personalized knowledge moms and expecting parents need to understand their unique pregnancy and determine their risk for complications. We also open a window for providers to implement preventive and proactive treatments.

Now is the time for pregnancy health care to progress and catch up to other specialties. I’m optimistic about the future and the incredible technologies that we can provide to mothers and their health care providers. Ultimately, we have the tools in our hands to better tackle pregnancy complications. This is an exciting time for health care and science, and we are committed to this historic opportunity to modernize pregnancy health and empower moms and expecting parents to take control of their health and well-being.