Cell-free DNA methylation-based preeclampsia prediction: A journey to improve maternal health

Presymptomatic prediction of preeclampsia (PE) is crucial to enable early prophylactic treatment. Current screening tools are either complex or lack predictive value. We recently demonstrated that cell-free DNA methylation can be leveraged to predict early-onset PE in 57% at a 10% false positive rate. Importantly, this minimally invasive screening test can be implemented as an add-on to current widespread noninvasive prenatal aneuploidy screening. Here, we highlight the pitfalls and promising prospects of this research. What is already known about this topic?Early, presymptomatic detection of preeclampsia (PE) is key to enable adequate pregnancy management and follow-up, including administration of prophylactic low-dose aspirinWe recently demonstrated that analysis of cell-free DNA methylation in the first trimester enables early-onset PE predictionWhat does this study add?We here contextualize our work within a wider framework, highlighting its current limitations and exciting future aspects