The underlying biology of pregnancy has long been shrouded in mystery. And increasingly, research is linking what happens during pregnancy to a person’s health over the course of their lifetime.
Our latest blog post features a conversation with Samir Kaul, founding partner and managing director of Khosla Ventures, and Maneesh Jain, Mirvie CEO and co-founder. Samir and Maneesh discuss innovations in pregnancy health and how these breakthroughs can provide earlier opportunities to intervene, ultimately creating better outcomes for moms and their babies.
Maneesh: The massive unmet need in women’s health has been well-documented. What are some factors that have historically been holding the field back in terms of innovation, and what breakthroughs could propel it forward?
Samir: First, let’s set the context. Women fuel the U.S. healthcare system. In actual resource allocation, for every dollar spent on men in healthcare, $1.20 is spent on women.
One reason behind this is women actually seek out care more proactively while men often avoid going to the doctor unless something is really bothering them. Additionally, women are most often the healthcare decision-makers in the home for their families, from choosing insurance to selecting a provider and coordinating care.
So despite being drivers of healthcare, women’s own health needs have been historically under-resourced and under-researched and thus, less understood. In terms of pregnancy, the first two trimesters are such a sensitive time for pregnant women. We now understand that this window is the best opportunity to intervene to prevent complications and create better health outcomes.
This clarity on how early interventions in utero impact lifetime health makes an obvious target on where you want to put your energy and investment. Mirvie is pioneering new technology and science to create the breakthroughs we desperately need.
Maneesh: Your thinking is spot on: women's health is family health. One staggering statistic is that pregnancy is more dangerous today than it was 20 years ago. In contrast, breakthroughs have been plentiful in oncology and cardiology. What are your thoughts on new tools and technologies that could be deployed to accelerate progress in maternal health?
Samir: A molecular diagnostic is often close to the ground truth of biology and what's happening in the body.
We have seen cell-free DNA take off in the molecular diagnostic space, like the NIPT test. This test has had a tremendous impact on maternal health, especially as more women are having babies in their late 30s and 40s. However, a limitation is that it only samples DNA—the static blueprint of an individual.
This is where RNA comes in and it’s at the heart of what Mirvie is building. RNA influences cellular processes and development, which provides a magnitude of data to conceptualize and interpret. As a fetus develops, it releases RNA across the development stages, sharing a whole host of information on what’s going on in the womb, to help predict complications well in advance.
With Mirvie’s technology, we’re learning brand new insights about fetal development and how the placenta can influence the health of both mom and baby in a whole new way.
Maneesh: Just 20 years ago it was extremely challenging to examine the expression of a single gene at a time, and now we can do the whole transcriptome routinely, and do it across thousands of patients.
Khosla Ventures has invested in women’s health beyond what Mirvie is doing. What other innovations are the most exciting to you?
Samir: When it comes to women’s health, one area we’ve focused on is fertility. Most patients don't have any visibility into what happens in the lab. We’ve invested in a company called Overture, which has developed a microfluidics automated system for the most complex processes involved in assisted reproductive technology. The goal is to create better outcomes and reduce costs for families undergoing fertility treatments like IVF.
Maneesh: An overall theme I’m taking away from this discussion, and something we are very focused on at Mirvie, is early intervention creates better outcomes. How has this worked in other fields of medicine?
Samir: The use of statins to lower low-density lipoproteins (LDLs) or “bad” cholesterol is a great example of early intervention creating better outcomes. By examining target risk factors and recommending evidence-based strategies on medicine and lifestyle changes, you can save lives. The more we understand about pregnancy health, the more opportunities for intervention and better outcomes are emerging for us. What Mirvie is doing is going to be very powerful. I think it's a direct analogy to the Framingham Study that created one of the biggest blockbuster areas of all - statins. It used to take decades to even get the discovery, and then build the drug on top of it. We now have access to computational discovery tools, and novel diagnostic modalities are taking research to new heights.
There’s still so much to uncover in maternal health and fetal development. Mirvie’s research and science will harness all the data we’ve never before had access to, creating new breakthroughs and insights into early interventions for the best outcomes for both mom and baby.
