Abstract
The technical capstone summarized in the following pages focuses on developing a specific, rapid urine-based test for at-home preeclampsia (PE) risk screening. PE is a hypertensive disorder of pregnancy that typically arises after 20 weeks of gestation, with symptoms that mimic those of other diseases, making PE difficult to diagnose (“Gestational Hypertension and Preeclampsia,” 2020). While there is a blood test that detects specific biomarkers associated with PE progression, blood tests are invasive, require specialized laboratory equipment and personnel, and can have long turnaround times for results (Atluri et al., 2023; B·R·A·H·M·S Lab Solutions, n.d.). Urine tests alleviate many of the complications of blood tests; therefore, a urine test that detects one or more of the aforementioned biomarkers would be more accessible to women (Sequeira-Antunes & Ferreira, 2023; Tang et al., 2017). A computational model simulating the detection of biomarkers was developed to confirm that urinary concentrations associated with PE are detectable and can be used for screening purposes. Results from future work will ideally be able to better inform women of their likelihood of developing PE, and encourage them to seek timely prenatal care.
The Science, Technology, and Society (STS) research paper included in this portfolio asks how sociotechnical factors, including healthcare infrastructure, patient trust, professional authority, affordability, and communication, shape the acceptance and use of at-home diagnostic devices for early detection of preeclampsia. The research is significant because preeclampsia affects approximately 2–8% of pregnancies and remains a leading cause of maternal and fetal morbidity and mortality, where early detection is critical but often limited by barriers to consistent prenatal screening (Atluri et al., 2023; “Gestational Hypertension and Preeclampsia,” 2020). Emerging urine-based diagnostics that detect biomarkers offer a potential solution for early, noninvasive at-home screening, but raise sociotechnical questions about integration into healthcare systems. The primary analytical framework is Actor-Network Theory (ANT), which conceptualizes technologies as part of networks in which human and nonhuman actors, including patients, healthcare providers, diagnostic devices, clinical guidelines, and regulatory structures, collectively influence outcomes (Cresswell et al., 2010). Methodologically, the study uses a sociotechnical systems perspective, combined with ethics of care and biomedical ethics, and relies on qualitative analysis of secondary sources including peer-reviewed literature and public health reports.
The evidence shows that at-home diagnostic devices for preeclampsia are shaped not only by technical performance, but by their embedding within sociotechnical systems that influence trust, access, and decision-making. These devices shift responsibility from healthcare providers to patients, requiring interpretation of results and follow-up decisions, which can increase autonomy but also create uncertainty and burden. Trust is closely tied to providers, regulators, and manufacturers, while affordability, infrastructure, and education strongly affect access and outcomes. In addition to ANT, the analysis draws on ethics of care and biomedical ethics to evaluate equity, responsibility, and patient autonomy (Principles of Bioethics | UW Department of Bioethics & Humanities, n.d.). The study concludes that these technologies can improve early detection and access, but only when supported by strong sociotechnical networks; otherwise, they risk identifying risk without enabling resolution and may reinforce disparities in maternal health outcomes.
