TEST TO PREDICT PREMATURE BIRTH
Testing for the
presence of specific molecules present in the urine of pregnant women can give
an indication in early pregnancy of whether a baby will be born premature or
the fetus will suffer poor growth, according to research published in the open
access journal BMC Medicine. Identifying these
conditions early in pregnancy could potentially help reduce complications and
manage any difficulties, although more work is needed before the findings can
be translated to clinical settings.
Researchers from
Imperial College London and the University of Crete analyzed the metabolites --
small molecules excreted in urine -- of 438 pregnant women in the Rhea cohort.
They found that elevated urinary levels of the amino acid lysine were
associated with spontaneous premature birth. In contrast, increased levels of a
N-acetylated glycoprotein -- a molecule consisting of a carbohydrate and a
protein -- tended to be found in women who had to be induced early. Decreased
levels of a third group of molecules: acetate, formate, tyrosine and trimethylamine
were associated with poor fetal development. Women with decreased levels of
these urine metabolites also showed signs of an increased risk of diabetes,
such as higher blood insulin.
The Rhea cohort is a
large population case-control mother-child study that started in Crete in 2007.
Urine samples were collected early in pregnancy at the first ultrasound
appointment. Preterm birth and fetal growth restriction has been shown to
increase the chance of developing metabolic and cardiovascular disorders later
in life.
Hector Keun, lead
researcher from the Department of Surgery and Cancer at Imperial College
London, says: "While we know that metabolism in the mother changes
substantially during pregnancy to help supply the growing fetus with nutrients,
we were surprised to see so early in pregnancy a link between metabolites that
we could easily detect in a urine sample and low birthweight. Our findings
imply that it could be possible to improve the identification of women at
higher risk of delivering smaller babies or premature delivery using
non-invasive metabolic profiling technology early in pregnancy."
Further research
needs to focus on whether changes in these metabolites are induced by pregnancy
or indicate an underlying risk factor. It also remains to be seen if these
results can be applied to a wider population and more research is needed before
any such test could be used in practice.
Hector Keun says:
"Future investigation of the factors that produce the molecules associated
with these pregnancy outcomes should improve our understanding of the genetic
and environmental factors that influence restricted fetal growth and thus help
us to reduce the likelihood of these events. We will also go on to test if
exposure to these metabolites during pregnancy has a lasting impact on child
development after birth."
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