Testing for the presence of specific molecules
present in the urine of pregnant women can give
an indication in early pregnancy of whether a
baby will be born premature or the fetus will
suffer poor growth, according to research
published in the open access journal BMC
Medicine. Identifying these conditions early in
pregnancy could potentially help reduce
complications and manage any difficulties,
although more work is needed before the findings
can be translated to clinical settings.
Researchers from Imperial College London and
the University of Crete analyzed the metabolites
— small molecules excreted in urine — of 438
pregnant women in the Rhea cohort. They found
that elevated urinary levels of the amino acid
lysine were associated with spontaneous
premature birth. In contrast, increased levels of a
N-acetylated glycoprotein — a molecule
consisting of a carbohydrate and a protein —
tended to be found in women who had to be
induced early. Decreased levels of a third group
of molecules: acetate, formate, tyrosine and
trimethylamine were associated with poor fetal
development. Women with decreased levels of
these urine metabolites also showed signs of an
increased risk of diabetes, such as higher blood
insulin.
The Rhea cohort is a large population case-
control mother-child study that started in Crete
in 2007. Urine samples were collected early in
pregnancy at the first ultrasound appointment.
Preterm birth and fetal growth restriction has
been shown to increase the chance of developing
metabolic and cardiovascular disorders later in
life.
Hector Keun, lead researcher from the
Department of Surgery and Cancer at Imperial
College London, says: “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 birth weight. 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.”
Further research needs to focus on whether
changes in these metabolites are induced by
pregnancy or indicate an underlying risk factor. It
also remains to be seen if these results can be
applied to a wider population and more research
is needed before any such test could be used in
practice.
Hector Keun says: “Future investigation of the
factors that produce the molecules associated
with these pregnancy outcomes should improve
our understanding of the genetic and
environmental factors that influence restricted
fetal growth and thus help us to reduce the
likelihood of these events. We will also go on to
test if exposure to these metabolites during
pregnancy has a lasting impact on child
development after birth.”
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