Mirvie seems cool and useful, but you overstate its usefulness. Problems with your post:
1. From your post: "For otherwise low risk women, the test is 91% sensitive in predicting those who will develop the disease. Those who test negative can also be confidently reassured – it correctly identifies those who will not develop the disease 99.7% of the time."
From the paper: "We show that cfRNA signatures from a single blood draw can track pregnancy progression at the placental, maternal and fetal levels and can robustly predict pre-eclampsia, with a sensitivity of 75% and a positive predictive value of 32.3% (s.d., 3%)".
I understand there might be subsequent analyses that show the 91% and 99.7% data, but it's not in the paper. And also, if you're going to do subgroup analysis (i.e. for low risk), you need to prespecify.
2. The study only addresses pre-term eclampsia, and, as far as I can tell, Mirvie only claims to predict pre-term eclampsia. Deena had post-term eclampsia, which there's no evidence Mirvie can predict (and I don't think they claim to).
Thanks for your note Trevor! All good points -- please see Carrie's comments for clarification on the state of the science. Also, while postpartum preeclampsia is not the current focus, the data indicate it is likely to be a distinct condition from antepartum preeclampsia. The potential for a more targeted way of anticipating and treating is what I'm most excited about
Thanks, Trevor. Yeah, it looks like you are quoting from the original discovery paper that Mirvie published in Nature in 2022. (https://www.nature.com/articles/s41586-021-04249-w) That was a very exciting paper, of course. Mirvie recently published further discovery and clinical validation work in a large, prospective, representative pregnancy population in Nature Communications (April 2025).(https://www.nature.com/articles/s41467-025-58157-y) The quoted stats in Dr. Shah's article are from this recent paper and analysis was indeed prespecified for patients without high risk factors for preeclampsia.
The 2025 Nature Communications paper shows that preeclampsia has multiple molecular subtypes and that preterm preeclampsia (placental driven) is a distinct condition from preeclampsia at term (immune driven). The Encompass Preeclampsia Test is optimized to predict preterm preeclampsia, but also does predict risk of preeclampsia or gestational hypertension cases that are more mild, may occur at term, or even postpartum.
It is not a mystery. It is just that OB's cannot fathom that the fetal baby body and placenta can only save itself by causing hypertension in an undernourished or under-oxygenated maternal body (distal vasculature in maternal body represents fetal vasculature), and with end organ damage as the positive biomarkers, it should not be a mystery that the fetus is trying to improve gas and nutrient diffusion in a deplete maternal system. Mom is not breathing deep enough, heart and lungs are not functioning "enough" and the maternal blood is not or has not been nutritious enough to fulfill the requirement the fetus needs to be well and growing. Why can't we imagine this scenario as a way the fetus is communicating that it needs more. Some moms think they are healthy but have no idea that they are not because they never before stressed their systems like a pregnancy does. And current lifestyle does not mean the maternal body had not over come a childhood, or other environment that limited the maternal body's overall vitality and capacity. I prevent Pre-E in my patients with over nourishment, deep lung exercises and cardio exercise. I have reversed! Pre-E numbers by forcing cardio pulmonary exercise BID into my pt's day, and have seen those biomarkers of organ death reverse. Recruit the most distal and often collapsed alvioli. Movement! Yes, move the muscles and nutrient rich blood (prelabor and IN labor). Stay relaxed and happy to get blood further into the tissues (parasympathetics/let go of fear). It works!! The health restored to those distal capillary beds and healing done, as I am sure is a measure of how that fetus is also experiencing more oxygen and nutritious blood to make its own body happy. This will one day be known, but until then, I am willing to be the crazy doctor that no one will listen to. Try this out, and really care, and do home BPs BID, and you will see. PreE can be reversed at its earliest moments before distal anoxic tissue damage occurs. It looks like what CHF would look like in a young person’s body with tight responses.
It is not a mystery. It is just that OB's cannot fathom that the fetal baby body and placenta can only save itself by causing hypertension in an undernourished or under-oxygenated maternal body (distal vasculature in maternal body represents fetal vasculature), and with end organ damage as the positive biomarkers, it should not be a mystery that the fetus is trying to improve gas and nutrient diffusion in a deplete maternal system. Mom is not breathing deep enough, heart and lungs are not functioning "enough" and the maternal blood is not or has not been nutritious enough to fulfill the requirement the fetus needs to be well and growing. Why can't we imagine this scenario as a way the fetus is communicating that it needs more. Some moms think they are healthy but have no idea that they are not because they never before stressed their systems like a pregnancy does. And current lifestyle does not mean the maternal body had not over come a childhood, or other environment that limited the maternal body's overall vitality and capacity. I prevent Pre-E in my patients with over nourishment, deep lung exercises and cardio exercise. I have reversed! Pre-E numbers but forcing cardio pulmonary exercise BID into my pt's day, and have seen those biomarkers of organ death reverse. Recruit the alvioli. Movement! Yes, move the muscles and nutrient rich blood (prelabor and IN labor). Stay relaxed and happy to get blood further into the tissues. It works!! The health restored to those distal capillary beds and healing done, as I am sure is a measure of how that fetus is also experiencing more oxygen and nutritious blood to make its own body happy. This will one day be known, but until then, I am willing to be the crazy doctor that no one will listen to. Try this out, and really care, and do home BPs BID, and you will see. PreE can be reversed at its earliest moments before distal anoxic tissue damage occurs. It looks like what CHF would look like in a young person’s body with tight responses.
Mirvie seems cool and useful, but you overstate its usefulness. Problems with your post:
1. From your post: "For otherwise low risk women, the test is 91% sensitive in predicting those who will develop the disease. Those who test negative can also be confidently reassured – it correctly identifies those who will not develop the disease 99.7% of the time."
From the paper: "We show that cfRNA signatures from a single blood draw can track pregnancy progression at the placental, maternal and fetal levels and can robustly predict pre-eclampsia, with a sensitivity of 75% and a positive predictive value of 32.3% (s.d., 3%)".
I understand there might be subsequent analyses that show the 91% and 99.7% data, but it's not in the paper. And also, if you're going to do subgroup analysis (i.e. for low risk), you need to prespecify.
2. The study only addresses pre-term eclampsia, and, as far as I can tell, Mirvie only claims to predict pre-term eclampsia. Deena had post-term eclampsia, which there's no evidence Mirvie can predict (and I don't think they claim to).
Thanks for your note Trevor! All good points -- please see Carrie's comments for clarification on the state of the science. Also, while postpartum preeclampsia is not the current focus, the data indicate it is likely to be a distinct condition from antepartum preeclampsia. The potential for a more targeted way of anticipating and treating is what I'm most excited about
Thanks, Trevor. Yeah, it looks like you are quoting from the original discovery paper that Mirvie published in Nature in 2022. (https://www.nature.com/articles/s41586-021-04249-w) That was a very exciting paper, of course. Mirvie recently published further discovery and clinical validation work in a large, prospective, representative pregnancy population in Nature Communications (April 2025).(https://www.nature.com/articles/s41467-025-58157-y) The quoted stats in Dr. Shah's article are from this recent paper and analysis was indeed prespecified for patients without high risk factors for preeclampsia.
The 2025 Nature Communications paper shows that preeclampsia has multiple molecular subtypes and that preterm preeclampsia (placental driven) is a distinct condition from preeclampsia at term (immune driven). The Encompass Preeclampsia Test is optimized to predict preterm preeclampsia, but also does predict risk of preeclampsia or gestational hypertension cases that are more mild, may occur at term, or even postpartum.
Thanks @Carrie and @Neel. Appreciate your responses and the link to the updated paper.
I am VP of Product at Mirvie (not sure that shows up in my profile).
It is not a mystery. It is just that OB's cannot fathom that the fetal baby body and placenta can only save itself by causing hypertension in an undernourished or under-oxygenated maternal body (distal vasculature in maternal body represents fetal vasculature), and with end organ damage as the positive biomarkers, it should not be a mystery that the fetus is trying to improve gas and nutrient diffusion in a deplete maternal system. Mom is not breathing deep enough, heart and lungs are not functioning "enough" and the maternal blood is not or has not been nutritious enough to fulfill the requirement the fetus needs to be well and growing. Why can't we imagine this scenario as a way the fetus is communicating that it needs more. Some moms think they are healthy but have no idea that they are not because they never before stressed their systems like a pregnancy does. And current lifestyle does not mean the maternal body had not over come a childhood, or other environment that limited the maternal body's overall vitality and capacity. I prevent Pre-E in my patients with over nourishment, deep lung exercises and cardio exercise. I have reversed! Pre-E numbers by forcing cardio pulmonary exercise BID into my pt's day, and have seen those biomarkers of organ death reverse. Recruit the most distal and often collapsed alvioli. Movement! Yes, move the muscles and nutrient rich blood (prelabor and IN labor). Stay relaxed and happy to get blood further into the tissues (parasympathetics/let go of fear). It works!! The health restored to those distal capillary beds and healing done, as I am sure is a measure of how that fetus is also experiencing more oxygen and nutritious blood to make its own body happy. This will one day be known, but until then, I am willing to be the crazy doctor that no one will listen to. Try this out, and really care, and do home BPs BID, and you will see. PreE can be reversed at its earliest moments before distal anoxic tissue damage occurs. It looks like what CHF would look like in a young person’s body with tight responses.
It is not a mystery. It is just that OB's cannot fathom that the fetal baby body and placenta can only save itself by causing hypertension in an undernourished or under-oxygenated maternal body (distal vasculature in maternal body represents fetal vasculature), and with end organ damage as the positive biomarkers, it should not be a mystery that the fetus is trying to improve gas and nutrient diffusion in a deplete maternal system. Mom is not breathing deep enough, heart and lungs are not functioning "enough" and the maternal blood is not or has not been nutritious enough to fulfill the requirement the fetus needs to be well and growing. Why can't we imagine this scenario as a way the fetus is communicating that it needs more. Some moms think they are healthy but have no idea that they are not because they never before stressed their systems like a pregnancy does. And current lifestyle does not mean the maternal body had not over come a childhood, or other environment that limited the maternal body's overall vitality and capacity. I prevent Pre-E in my patients with over nourishment, deep lung exercises and cardio exercise. I have reversed! Pre-E numbers but forcing cardio pulmonary exercise BID into my pt's day, and have seen those biomarkers of organ death reverse. Recruit the alvioli. Movement! Yes, move the muscles and nutrient rich blood (prelabor and IN labor). Stay relaxed and happy to get blood further into the tissues. It works!! The health restored to those distal capillary beds and healing done, as I am sure is a measure of how that fetus is also experiencing more oxygen and nutritious blood to make its own body happy. This will one day be known, but until then, I am willing to be the crazy doctor that no one will listen to. Try this out, and really care, and do home BPs BID, and you will see. PreE can be reversed at its earliest moments before distal anoxic tissue damage occurs. It looks like what CHF would look like in a young person’s body with tight responses.