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Identifying metabolite markers for preterm birth in cervicovaginal fluid by magnetic resonance spectroscopy.


ABSTRACT:

Introduction

Preterm birth (PTB) may be preceded by changes in the vaginal microflora and metabolite profiles.

Objectives

We sought to characterise the metabolite profile of cervicovaginal fluid (CVF) of pregnant women by 1H NMR spectroscopy, and assess their predictive value for PTB.

Methods

A pair of high-vaginal swabs was obtained from pregnant women with no evidence of clinical infection and grouped as follows: asymptomatic low risk (ALR) women with no previous history of PTB, assessed at 20-22 gestational weeks, g.w., n = 83; asymptomatic high risk (AHR) women with a previous history of PTB, assessed at both 20-22 g.w., n = 71, and 26-28 g.w., n = 58; and women presenting with symptoms of preterm labor (PTL) (SYM), assessed at 24-36 g.w., n = 65. Vaginal secretions were dissolved in phosphate buffered saline and scanned with a 9.4 T NMR spectrometer.

Results

Six metabolites (lactate, alanine, acetate, glutamine/glutamate, succinate and glucose) were analysed. In all study cohorts vaginal pH correlated with lactate integral (r = -0.62, p < 0.0001). Lactate integrals were higher in the term ALR compared to the AHR (20-22 g.w.) women (p = 0.003). Acetate integrals were higher in the preterm versus term women for the AHR (20-22 g.w.) (p = 0.048) and SYM (p = 0.003) groups; and was predictive of PTB < 37 g.w. (AUC 0.78; 95 % CI 0.61-0.95), and delivery within 2 weeks of the index assessment (AUC 0.84; 95 % CI 0.64-1) in the SYM women, whilst other metabolites were not.

Conclusion

High CVF acetate integral of women with symptoms of PTL appears predictive of preterm delivery, as well as delivery within 2 weeks of presentation.

SUBMITTER: Amabebe E 

PROVIDER: S-EPMC4783437 | biostudies-literature | 2016

REPOSITORIES: biostudies-literature

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Publications

Identifying metabolite markers for preterm birth in cervicovaginal fluid by magnetic resonance spectroscopy.

Amabebe Emmanuel E   Reynolds Steven S   Stern Victoria L VL   Parker Jennifer L JL   Stafford Graham P GP   Paley Martyn N MN   Anumba Dilly O C DO  

Metabolomics : Official journal of the Metabolomic Society 20160308


<h4>Introduction</h4>Preterm birth (PTB) may be preceded by changes in the vaginal microflora and metabolite profiles.<h4>Objectives</h4>We sought to characterise the metabolite profile of cervicovaginal fluid (CVF) of pregnant women by 1H NMR spectroscopy, and assess their predictive value for PTB.<h4>Methods</h4>A pair of high-vaginal swabs was obtained from pregnant women with no evidence of clinical infection and grouped as follows: asymptomatic low risk (ALR) women with no previous history  ...[more]

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