Growth failure, accelerated weight gain, cardiovascular disorders and other health problems in childhood are associated with preterm birth and fetal growth restriction.
A new, non-invasive test could
be used in early pregnancy to predict preterm birth and poor fetal development.
Growth failure, accelerated weight gain, cardiovascular
disorders and other health problems in childhood are associated with preterm
birth and fetal growth restriction.
Preterm birth is defined as being when a baby is born before the
37th week of pregnancy. Fetal growth restriction is when a newborn's birth
weight falls below the 10th percentile of their predicted birth weight.
Preterm birth is becoming more
common - over the past 10 years it has increased by 19.4% in developed regions,
with the US accounting for 42% of all preterm births in 2010.
A recent report also found that Greece has seen a sharp increase
in preterm birth over the past 20 years. The new study, therefore, examined a
cohort of mothers and children from Crete in an attempt to find molecular
biomarkers that may form the basis of a screening test to predict preterm birth
or fetal growth restriction.
The new study builds on previous research along these lines, and
is the largest study in humans so far to examine urinary metabolomics for predicting
risk of preterm birth and fetal growth restriction.
The researchers wondered if abnormalities in lipid storage and
some metabolic pathways in the first trimester could predict fetal growth
impairment. This is because extensive changes of these factors are necessary in
the first trimester to facilitate the development of the fetus.
The team analyzed the
metabolites found in the urine of 438 pregnant women, and detected that
elevated levels of the amino acid lysine were associated with spontaneous preterm
birth. They also discovered that increased levels of an N-acetylated
glycoprotein were found in women who had to be induced early.
Metabolic biomarkers
were also identified for poor fetal development. Decreased levels of the
molecules acetate, formate, tyrosine and trimethylamine, were associated with
fetal growth restriction. What is more, women with decreased levels of these
metabolites were found to be at higher risk of diabetes, as they may have higher blood insulin.
Hector Keun, lead researcher from the Department of Surgery and
Cancer at Imperial College London in the UK, describes the findings:
"While we know that metabolism in the
mother changes substantially during pregnancy to help supply the growing fetus
with nutrients, we were surprised to see so early in pregnancy a link between
metabolites that we could easily detect in a urine sample and low birthweight.
Our findings imply that it could be possible
to improve the identification of women at higher risk of delivering smaller
babies or premature delivery using non-invasive metabolic profiling technology
early in pregnancy."
Keun says that further investigation of the factors that produce
the molecules associated with preterm birth and poor fetal development will
help to reduce the likelihood of these harmful pregnancy outcomes.
"We will also go on to test if exposure to these
metabolites during pregnancy has a lasting impact on child development after
birth," he adds. The team will repeat the study in several more countries
to understand the causal factors behind the observations.
As for why preterm
birth has become so much more common in first world countries such as Greece
and the US, Keun told Medical News Today that the
answer is not yet clear, "but the rate of the rise suggests an
environmental and not genetic cause, and it is these environmental factors that
we are actively researching."
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