Metabolomics applied to maternal and perinatal health: a review of new frontiers with a translation potential

Abstract

The prediction or early diagnosis of maternal complications is challenging mostly because the main conditions, such as preeclampsia, preterm birth, fetal growth restriction, and gestational diabetes mellitus, are complex syndromes with multiple underlying mechanisms related to their occurrence. Limited advances in maternal and perinatal health in recent decades with respect to preventing these disorders have led to new approaches, and “omics” sciences have emerged as a potential field to be explored. Metabolomics is the study of a set of metabolites in a given sample and can represent the metabolic functioning of a cell, tissue or organism. Metabolomics has some advantages over genomics, transcriptomics, and proteomics, as metabolites are the final result of the interactions of genes, RNAs and proteins. Considering the recent “boom” in metabolomic studies and their importance in the research agenda, we here review the topic, explaining the rationale and theory of the metabolomic approach in different areas of maternal and perinatal health research for clinical practitioners. We also demonstrate the main exploratory studies of these maternal complications, commenting on their promising findings. The potential translational application of metabolomic studies, especially for the identification of predictive biomarkers, is supported by the current findings, although they require external validation in larger datasets and with alternative methodologies.

Sex Affects Human Premature Neonates’ Blood Metabolome According to Gestational Age, Parenteral Nutrition, and Caffeine Treatment

“…Prematurity, defined as childbirth before 37 weeks of gestation, annually affects 9.6% of pregnancies [ 1 , 2 ], being the 84% of preterm births of the so-called moderate or late preterm infants (MLPI) [ 3 ]. Relevantly, prematurity may have negative consequences for the family and the infants, during both child and adult life, and the healthcare system.…”

How could metabolomics change pediatric health?

“…In conclusion, a metabolomic approach in different areas of maternal and perinatal medicine could really help in a best characterization of such conditions and in the identification of novel biomarkers, even if the current findings still require further validation on larger cohorts [32].…”

“…In the evaluation of pre-and peri-conceptional factors, preterm birth and labor, intrauterine growth restriction (IUGR), maternal gestational diabetes (GDM), preeclampsia (PE), fetal infections, exposition to hyperoxia during post-natal life, potentially related to epigenetic changes on DNA [31], metabolomics application could give great advantages, both in the comprehension, diagnosis and treatment of such conditions and represents a promising field to investigate [32].…”

“…The early diagnosis of the prediction of several maternal complications represents a challenge due to the high complexity of these conditions, still partially understood [32].…”

Associations of prenatal metabolomics profiles with early childhood growth trajectories and obesity risk in African Americans: the CANDLE study

“…The emerging metabolomics technology, which can systematically profile small molecules in biofluids, cells, and tissues, has been applied in the research of perinatal health ( 17 ), such as gestational diabetes ( 18 ), fetal growth restriction ( 19 , 20 ), and preterm birth ( 21 ). These studies demonstrate that prenatal metabolomics changes are underlying the pathogenesis of maternal complications during pregnancy and fetal intrauterine development.…”