Mother Nurture

by April White
Photography by Mitch Tobias
Maneesh Jain, PhD (BS ’90) has spent his career seeking out the next scientific frontier, where rapid innovation can make a significant difference in people’s lives. Today, he says, that frontier is maternal health research.
The need for such work is obvious: In 2020, a woman died every two minutes from preventable pregnancy-related causes, according to the World Health Organization. The risk to mothers has long been highest in sub-Saharan Africa, but in recent years, North America and Europe have seen an increasing number of deaths among pregnant people and those who have recently given birth. In the United States, the maternal mortality rate nearly doubled between 2014 and 2021, with the biggest increase in risk among Black women.

“We’ve gone backwards in the last two decades, and that’s staggering,” says Jain, a serial biotech entrepreneur. Part of the problem is that maternal health has been historically understudied—but there is a ready remedy: Jain believes that many of the same scientific advancements in genomics and machine learning that have, for instance, led to earlier cancer diagnoses, can also be used to identify pregnancy complications months before dangerous symptoms arise. Pregnancy doesn’t have to be a “black box,” he says, and in 2018 he cofounded Mirvie, a startup developing RNA analysis tools, to prove it.

This isn’t what Jain thought he would be doing when he was studying at Caltech in the late 1980s. After a freshman year Summer Undergraduate Research Fellowship project, he planned to pursue a career in laser physics. But while he enjoyed the work, “I was a few decades too late,” he says. Laser physics research had been pioneered in the 1960s; Jain wanted to be a part of a groundbreaking moment like that. “I got quite curious about what field might be approaching that frontier stage, entering a ‘golden decade’ where all the advances are so new that you are really pushing the field forward rapidly,” Jain recalls. In the mid-1990s, that curiosity led him to the Human Genome Project—an international effort to map human DNA. Such knowledge, Jain believed, would provide the launching pad for scientific discovery in the 21st century.

Jain had also expected to spend his career in the lab, but as industry began to join academia in advancing the field of genomics, Jain saw an advantage in entrepreneurship: “I got to see just how fast industry can move in making a product that can impact lives.”

In the 2000s, during what he considers genomics’s first “golden decade,” Jain launched a biotech startup to help scale genetic analysis, giving scientists the tools to evaluate 20,000-plus genetic changes at a time, and another with the goal of creating a more affordable benchtop device to sequence the genome. “The field was really young,” he says. “The first companies were focused on how we could do data generation more efficiently.”

In the second golden decade, Jain turned his entrepreneurial attention to applying this new data to an area where it could have the most impact. He focused first on early cancer detection through “liquid biopsies”—basically, diagnosing cancer from the analysis of DNA in a blood sample instead of via an invasive tissue biopsy. Today, he sits on the board of directors for Adela, a company he cofounded, which is testing the effectiveness of this approach on a wide array of cancers.

Mirvie, Jain’s current company focused on maternal health, is taking the science one step further, analyzing the RNA in a blood sample. Unlike DNA, which never changes, RNA is dynamic and varies across tissues and over time. DNA analysis can identify, for instance, Down syndrome in a fetus, a condition determined by the genetic contributions of the parents at fertilization, but RNA can track complications that arise throughout a pregnancy—conditions such as preeclampsia. Preeclampsia is a hypertensive condition that occurs in an estimated one in twelve pregnancies in the United States and can lead to seizure, stroke, or even death. It is often signaled by high blood pressure in the third trimester.

Amit Kshatriya asks questions of participants during the Artemis II Mission Integration Review, a checkpoint in the lead-up to the first crewed Artemis mission.
Jain believes that many of the same scientific advancements in genomics and machine learning that have, for instance, led to earlier cancer diagnoses, can also be used to identify pregnancy complications months before dangerous symptoms arise.
“I got quite curious about what field might be approaching that frontier stage, entering a ‘golden decade’ where all the advances are so new that you are really pushing the field forward rapidly,” Jain recalls.
“But the biological basis for preeclampsia starts quite early, about the end of the first trimester or early in the second trimester,” Jain explains. Early research has shown Mirvie’s RNA analysis can detect preeclampsia months in advance of the emergence of symptoms in 75 percent of cases. Mirvie recently completed a larger 10,000-plus-person study in the United States, with plans to publish its results later in 2024, and a study of preeclampsia in sub-Saharan Africa is currently underway.

If pregnancy complications like preeclampsia can be diagnosed earlier, they can be treated earlier, hopefully with improved outcomes, Jain says. “We definitely don’t have all the treatments [in maternal health] that we do in oncology. We know that pregnancy health is probably two to three decades behind fields like oncology, but hopefully we can leapfrog and catch up pretty quickly.”

Jain is hopeful we are at the dawn of a third golden decade for genomics, a decade that will change lives for generations. “People still largely think of pregnancy as what happens in nine months or 40 weeks,” he says. But for mother and baby, “what happens in those weeks actually makes a lifetime impact.”

April White is the author of The Divorce Colony, the amazing true story of the 19th-century socialites who revolutionized marriage on the American frontier. Smithsonian MagazineMental Floss and Library Journal all named it one of the year’s best books, and the New York Daily News said, “It’s essential feminist history…it’s also a gossipy story of misogyny, millionaires, and murder.”  White’s writing has also appeared in publications including Atlas Obscura, Atavist Magazine and the Washington Post.

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