Alcohol is the leading known preventable cause of developmental and physical birth defects in the United States, according to Kidshealth.org, but despite that, many women still drink during pregnancy(either knowingly – or before they know they are pregnant). About 1 in every 750 infants is born with fetal alcohol syndrome and another 40,000 with fetal alcohol effects. To help identify damage to the fetus earlier so that better intervention is possible, a research team at Temple University School of Medicine is developing a test to identify maternal blood biomarkers that can assess fetal neurodevelopment in the first and second trimesters.
This project was a recent winner of Bill & Melinda Gates Foundation's Grand Challenges Explorations grants. Temple was one 60 winners who will focus on solving persistent global health and development challenges.
Dr. Laura Goetzl, Professor of Obstetrics, Gynecology and Reproductive Sciences and her research team will be working with the Shriners Hospitals Center for Neural Repair and Rehabilitation to develop a non-invasive maternal blood test that will help predict abnormal fetal neurodevelopment. Specifically they will be focusing on the effects of antidepressants, amphetamines and alcohol.
"We have been working on the effects of medication on the unborn fetus. Most of the available data is from the third trimester when everyone wants to know about early trimesters. Neural elements from the fetus can pass into the mother's blood stream and may be able to be used to measure ongoing brain injury," Dr. Goetzl said.
Inspired by work with biomarkers in Alzheimer's research and noninvasive maternal testing for Down Syndrome, they will be using special technology to identify what biomarkers are released from the baby's brain and cross over the placenta into the mother's blood.
"First, we will purify the blood to look for all neural markers. Then we will do further purification to determine what neural markers are the baby's and what are the mother's," she said.
Dr. Goetzl and her team hope to be able to identify brain injury in the fetus early so that there can be intervention and reduction of injury, but a lot of work still needs to be done. The initial grant is for 18 months and that is just to see if such a maternal blood test is possible. It could take up to 10 years to really know how well the new test will correlate with developmental outcomes and whether it can be used going forward to prevent neural injury.