Can metabolic profiling predict preterm delivery?

Metabolic profiling of amniotic fluid (AF) is a new way to identify which women experiencing preterm labor are also at risk for preterm delivery, with and without infection or inflammation, according to prize-winning research presented at the SMFM meeting. Researchers discovered biomarkers for preterm labor and delivery at the molecular level by successfully profiling the AF metabolome, which is the sum of all metabolic processes that occur in the AF.

Roberto Romero and his colleagues studied the AF of three groups of patients-all of whom had premature contractions with intact membranes: (1) 16 women with preterm labor who delivered at term, (2) 19 patients with intra-amniotic inflammation who had both preterm labor and preterm birth, and (3) 20 women who, despite showing no sign of inflammation, had preterm labor and delivery anyway. They performed AF metabolic profiling by combining chemical separation and mass spectrometry.

The researchers found that 96% of the time, they could accurately identify the patients as belonging to the appropriate clinical group. A second study of a different set of patients with a larger sample size has already confirmed the effectiveness of this method. The study was a joint effort between maternal-fetal medicine specialists from the National Institute of Child Health and Human Development, National Institutes of Health, and other groups.

Commentary by Charles J. Lockwood, MD, Yale University School of Medicine: Great caution should be exercised in interpreting these results, since frequently proteomic and metabolomic studies tend to produce results that are not translatable to other populations Therefore, it would be important to replicate these results.