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Metabolomic profiling of intrauterine growth-restricted preterm infants: a matched case-control study
Elena Priante1, Giovanna Verlato2, Matteo Stocchero3
1Department of Women's and Children's Health, Neonatal Intensive Care Unit, University Hospital of Padua, Padua, Italy. elena.priante@aopd.veneto.it.
Insights
Very preterm infants with intrauterine growth restriction (IUGR) exhibit unique urinary metabolic profiles at birth. This study highlights distinct biochemical adaptations in IUGR neonates, offering insights for personalized medicine approaches.
Area of Science:
- Neonatology
- Metabolomics
- Biochemistry
Background:
- Intrauterine growth restriction (IUGR) affects fetal growth potential, with underlying biochemical variations not fully understood.
- Early-onset IUGR in very preterm infants presents unique challenges in neonatal intensive care units (NICUs).
Purpose of the Study:
- To compare urinary metabolomic profiles between infants with and without IUGR born very preterm.
- To investigate biochemical adaptations in neonates affected by early-onset IUGR.
Main Methods:
- A prospective matched case-control study involving neonates born <32 weeks gestation.
- Untargeted metabolomic analysis of urine samples collected within 48 hours of life using LC-MS.
- Multivariate and univariate statistical analyses were employed for data interpretation.
Main Results:
- Distinct urinary metabolic profiles were observed in IUGR neonates compared to controls.
- Derangements in tryptophan and histidine metabolism, aminoacyl-tRNA, and steroid hormone biosynthesis pathways were identified in IUGR infants.
- Preliminary findings show significant clustering of IUGR neonates based on their metabolic profiles.
Conclusions:
- Neonates with IUGR display a distinctive urinary metabolic signature at birth.
- Metabolomics serves as a promising tool for elucidating biochemical pathways implicated in IUGR.
- Further research into metabolic derangements in IUGR may facilitate personalized medicine strategies.
Background:
The biochemical variations occurring in intrauterine growth restriction (IUGR), when a fetus is unable to achieve its genetically determined potential, are not fully understood. The aim of this study is to compare the urinary metabolomic profile between IUGR and non-IUGR very preterm infants to investigate the biochemical adaptations of neonates affected by early-onset-restricted intrauterine growth.
Methods:
Neonates born <32 weeks of gestation admitted to neonatal intensive care unit (NICU) were enrolled in this prospective matched case-control study. IUGR was diagnosed by an obstetric ultra-sonographer and all relevant clinical data during NICU stay were captured. For each subject, a urine sample was collected within 48 h of life and underwent untargeted metabolomic analysis using mass spectrometry ultra-performance liquid chromatography. Data were analyzed using multivariate and univariate statistical analyses.
Results:
Among 83 enrolled infants, 15 IUGR neonates were matched with 19 non-IUGR controls. Untargeted metabolomic revealed evident clustering of IUGR neonates versus controls showing derangements of pathways related to tryptophan and histidine metabolism and aminoacyl-tRNA and steroid hormones biosynthesis.
Conclusions:
Neonates with IUGR showed a distinctive urinary metabolic profile at birth. Although results are preliminary, metabolomics is proving to be a promising tool to explore biochemical pathways involved in this disease.
Impact:
Very preterm infants with intrauterine growth restriction (IUGR) have a distinctive urinary metabolic profile at birth. Metabolism of glucocorticoids, sexual hormones biosynthesis, tryptophan-kynurenine, and methionine-cysteine pathways seem to operate differently in this sub-group of neonates. This is the first metabolomic study investigating adaptations exclusively in extremely and very preterm infants affected by early-onset IUGR. New knowledge on metabolic derangements in IUGR may pave the ways to further, more tailored research from a perspective of personalized medicine.
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