Measuring hypoxia-induced RNA in maternal blood: a new way to identify critically hypoxic fetuses in utero?

Severe fetal hypoxia causes stillbirth and permanent childhood disability. Unfortunately, none of the current tests is precise at determining the degree of fetal hypoxia in utero. We recently showed that hypoxia-induced RNA abundance in the maternal circulation (of likely fetoplacental origin) was tightly correlated with the degree of fetal hypoxia, suggesting it may be possible to generate a maternal blood test to more precisely determine the severity of fetal hypoxia. Such a test could drastically improve outcomes and decrease stillbirth rates. We are running a large prospective study to validate this test, and will use microarrays, RNA-seq and digital PCR to identify RNA transcripts that best correlate with the severity of fetal hypoxia. Finally, we note our data hints at the possibility of measuring dynamic changes in the fetoplacental transcriptome, measured in serial maternal blood samples. This could afford exciting new insights into the pathology of major obstetric diseases.