Maternal urinary metabolomic signatures preceding spontaneous preterm birth: A pilot study

Area of Science:

• Reproductive biology
• Biomarker discovery
• Metabolomics

Background:

• Spontaneous preterm birth (sPTB) has diverse causes, complicating accurate risk prediction.
• Current methods for predicting sPTB lack sufficient accuracy, leading to misclassification in up to 40% of cases.
• Effective risk stratification is crucial for timely interventions and preventing adverse outcomes.

Purpose of the Study:

• To investigate signaling lipids in urine as potential biomarkers for spontaneous preterm birth (sPTB).
• To explore the utility of urinary metabolomics for differentiating preterm birth from term birth.
• To develop a predictive model for sPTB risk stratification.

Main Methods:

• Prospective collection of midstream urine from 30 women with imminent preterm birth.
• Retrospective classification of samples into preterm without chorioamnionitis, preterm with chorioamnionitis, and term groups.
• Analysis using liquid-chromatography mass-spectrometry to identify and quantify signaling lipids (oxylipins).

Main Results:

• Reduced levels of lipoxygenase- and cytochrome P450-derived oxylipins were observed in the preterm group, indicating impaired inflammation resolution.
• 8,9-DiHETrE and 9-HODE were identified as potential etiology-independent biomarkers for sPTB.
• A predictive model combining 9-HODE and vaginal discharge achieved an AUC of 84.2% for differentiating preterm from term delivery.

Conclusions:

• Urinary metabolomics offers a non-invasive approach to understanding sPTB pathophysiology.
• Signaling lipids, particularly 8,9-DiHETrE and 9-HODE, show promise as biomarkers for sPTB risk prediction.
• Improved risk stratification using these biomarkers can enhance clinical management of pregnancies at risk for preterm birth.