Metabolomics Application in Maternal-Fetal Medicine

Table 1

Methodology, findings, and main conclusions derived from metabolomics studies on maternal plasma.

Population	Gestational age at examination	Metabolomic analysis	Main differences in abnormal pregnancies	Significance/take-home messages	Reference	Author, year
20 normal pregnancies	Matched
27 fetal malformations	At diagnosis		Gluconeogenetic aminoacids, cis-aconitate, acetone, 3-hydroxibutirric, hypoxanthine	Pregnant women with malformed fetus showed enhanced glucogenesis and tricarboxylic acids cycle
23 chromosomal disorders	At diagnosis	NMR			[18]	Diaz et al., 2011
14 prediagnostic GDM	Before positive OGTT		3-Hydroxyisovalerate, 2-hydroxyisobutirrate	Pregnant women who later develop GDM showed early changes in biotin status and altered aminoacid and/or gut metabolism
18 pPROM	At diagnosis		No alterations
11 normotensive pregnancies; versus 11 preeclamptic pregnancies	n.r.	NMR	Hystidine, tyrosine, phenylalanine	Diagnosis of preeclampsia was possible by metabolomics	[28]	Turner et al., 2008
60 cases of PE versus matched controls	15 ± 1 weeks	UPLC-MS	40 metabolites (detection rate 71%, 5% false positive)	Metabolomics might predict preeclampsia, early and late PE not analysed separately	[26]	Kenny et al., 2010
41 cases of PE versus controls	First trimester	LS/MS	40 acylcarnitine species and 32 aminoacids (AUC-ROC = 0.85)	Metabolomics might predict early onset PE	[27]	Odibo et al., 2011
30 cases of early PE versus 60 controls	First trimester	NMR	Citrate, glycerol, hydroxyisovalerate, and methionine and uterine Doppler abnormal PI (detection rate of 82.6%, at an FPR of 1.6%)	Metabolomics might predict early onset PE	[7]	Bahado-Singh et al., 2012
30 cases of late PE versus 119 controls	First trimester	NMR	17 metabolites	Metabolomics might predict late onset PE	[8]	Bahado-Singh et al., 2013
Pregnant women who subsequently delivered an SGA baby	First trimester	UPLC-MS	19 metabolites (OR = 44; AUC-ROC = 0.90)	Metabolomics might predict SGA	[29]	Horgan et al., 2011

GDM: gestational diabetes mellitus; pPROM: preterm premature rupture of membranes; OGTT: oral glucose tolerance test; NMR: nuclear magnetic resonance spectroscopy; PE: preeclampsia; UPLC-MS: ultra performance liquid chromatography-mass spectrometry; LS/MS: liquid chromatography-mass spectrometry; SGA: small for gestational age.