Epidural-related maternal fever and metabolomic changes: a pilot exploratory study

Area of Science:

• Biochemistry
• Obstetrics
• Metabolomics

Background:

• The causes of intrapartum fever during labor epidural analgesia are not well understood.
• Metabolomics offers a way to analyze small molecules and understand biological processes.

Purpose of the Study:

• To explore the preliminary pathophysiological mechanisms of fever during labor epidural analgesia using metabolomic analysis.
• To identify potential biomarkers and pathways associated with fever in parturients.

Main Methods:

• Non-targeted metabolomic analysis of plasma samples from parturients with and without fever after labor epidural analgesia.
• Utilized principal component analysis, orthogonal partial least squares discriminant analysis, and ultra-high-performance liquid chromatography-quadrupole Orbitrap mass spectrometry.
• Assessed model reliability with 200 permutation tests.

Main Results:

• Identified 79 differential metabolites between the fever and control groups.
• Observed significant differences in glutamate, glutathione, arginine, and urea cycle metabolites.
• Top enriched pathways included arginine biosynthesis, glutamate metabolism, and the urea cycle.

Conclusions:

• Preliminary observation of metabolite alterations in parturients with fever post-epidural analgesia.
• Changes in the arginine metabolic pathway may be associated with fever development.
• Further large-scale studies are needed for validation.