Metabolic Dynamics and Prediction of Gestational Age and Time to Delivery in Pregnant Women

Highlights

• •Weekly metabolome of maternal blood changes dynamically through healthy pregnancy

• •A metabolic clock of five blood metabolites accurately predicts gestational age

• •Two to three metabolites identify labor onset within two, four, and eight weeks

• •Women with metabolic clocks that outpaced ultrasound evaluation tend to deliver earlier

Summary

Metabolism during pregnancy is a dynamic and precisely programmed process, the  failure of which can bring devastating consequences to the mother and  fetus. To define a high-resolution temporal profile of metabolites  during healthy pregnancy, we analyzed the untargeted metabolome of  784 weekly blood samples from 30 pregnant women. Broad changes and a  highly choreographed profile were revealed: 4,995 metabolic features (of 9,651 total), 460 annotated compounds (of 687 total), and 34 human  metabolic pathways (of 48 total) were significantly changed during  pregnancy. Using linear models, we built a metabolic clock with five  metabolites that time gestational age in high accordance with ultrasound (R = 0.92). Furthermore, two to three metabolites can identify when  labor occurs (time to delivery within two, four, and eight weeks, AUROC ≥ 0.85). Our study represents a weekly characterization of the human  pregnancy metabolome, providing a high-resolution landscape for  understanding pregnancy with potential clinical utilities.

Noninvasive blood tests for fetal development predict gestational age and preterm delivery      

     Science    . 2018 Jun 8;360(6393):1133-1136. doi: 10.1126/science.aar3819.