Metabolomics Application in Maternal-Fetal Medicine

Table 2

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

Population study	Gestational age at examination	Metabolomic analysis	Main results	Significance/take-home messages	Reference	Author, year
48 GDM cases versus 23 controls	Third; trimester	MS	Increased urinary excretion of P-IPG, positive correlation with blood glucose	Metabolomic identification of P-IPG is a potential marker of insulin resistance, may predict fetal growth alterations in GDM patients	[33]	Scioscia et al., 2007
9 PE cases versus 84 controls	First; trimester	Elisa-based assay	Rapid raise of P-IPG (sensitivity and specificity of 88.9% and 62.7%, resp.)	Metabolomics by multiple assessment of samples might predict preeclampsia	[32]	Paine et al., 2010
3083 pregnancies positive to the screening of Smith-Lemli-Opitz syndrome	Second; trimester	GC/MS	16α-OH-DHEA, urine total estriol. Fetal steroid sulfatase deficiency 98% detection rate, 95% CI 92–99	Metabolomics analysis of Maternal urine steroids is effective in detecting STSD. Possible use for diagnosing ADHD and CGDS (common in association with STSD)	[31]	Marcos et al., 2009
75 pregnancies (13 healthy)				Potential of the tandem use of MS and NMR for metabolomics studies of urine and amniotic fluid in pregnant women
13 fetal malformations			Hippurate, amino acids
20 predisposition to GDM	Second; trimester	UPLC-MS NMR	No relevant changes		[30]	Graça et al., 2012
6 preterm delivery			Methionine, phenylalanine, hystidine, hexose (possibly glucose)
26 preterm FGR versus 30 preterm appropriate for gestational age	Neonates	^1H NMR	Myoinositol, sarcosine, creatine, and creatinine	Metabolomics might identify FGR and contribute to the clinical management of FGR neonates	[34]	Dessì et al., 2011

GDM: gestational diabetes mellitus; MS: mass spectrometry; P-IPG: inositol phosphoglycan P type; PE: preeclampsia; GC/MS: gas chromatography-mass spectrometry; STSD: steroid sulfatase deficiency; ADHD: attention deficit-hyperactivity disorder; CGDS: contiguous gene deletion syndrome; UPLC-MS: ultra performance liquid chromatography-mass spectrometry; NMR: nuclear magnetic resonance spectroscopy; ¹H NMR: proton nuclear magnetic resonance spectroscopy; FGR: fetal growth restriction.