Metabolic Pathways Associated With Term Labor Induction Course in African American Women

Abstract

Objectives: The purpose of this study was to evaluate differences in the metabolic pathways activated in late-pregnancy serum samples among African American women who went on to have term (≥37 weeks) labor induction requiring high total oxytocin doses to complete first-stage labor compared to those in similar women with low-oxytocin labor inductions. Study Design: Case–control study ( N = 27 women with labor induction with successful cervical ripening: 13 requiring the highest total doses of synthetic oxytocin to progress from 4- to 10-cm cervical dilation and 14 requiring the lowest total doses) with groups balanced on parity and gestational age. Serum samples obtained between 24 and 30 weeks’ gestation were analyzed using ultra-high-resolution metabolomics. Differentially expressed metabolites between high-oxytocin induction cases and low-oxytocin induction comparison subjects were evaluated using linear regression with xmsPANDA. Metabolic pathways analysis was conducted using Mummichog Version 2.0, with discriminating metabolites annotated using xMSannotator Version 1.3. Results: Labor processes were similar by group with the exception that cases received over 6 times more oxytocin between 4- and 10-cm cervical dilation than comparison women. Induction requiring high total doses of synthetic oxytocin was associated with late-pregnancy serum levels of metabolites from the linoleate and fatty acid activation pathways in term, African American women. Conclusion: Serum levels of several lipid metabolites predicted more complicated labor induction involving higher doses of synthetic oxytocin to complete first-stage labor. Further investigation in larger, more diverse cohorts of women is needed to identify potential targets to prevent failed labor induction.

Maternal Myometrium Metabolomic Profiles in Labor: Preliminary Results

“…Most of the human metabolite profiling in parturition focused on maternal serum and amniotic fluid. Partly consistent with previous studies on mouse uterine muscle and human serum during labor [17, 18], we found that the greatest changes were observed in lipolysis and fatty acid oxidation between nonlabor and labor stages. Compared with patients from the nonlabor group, those from the labor group had increased myometrial levels of several fatty acids generated as byproducts of β-oxidation and decreased triacylglycerol level, presumably owing to increased lipolysis.…”

Metabolic Pathways Associated With Psychoneurological Symptoms in Children With Cancer Receiving Chemotherapy

“…The Benjamini-Hochberg FDR method (Hochberg & Benjamini, 1990) was used for multiplehypothesis correction to identify individual metabolites based on a q value of .20. As reported in previous literature (Carlson et al, 2020), the FDR correction protects against type I error but it may exclude true positive metabolites (type II error). Thus, metabolic pathways associated with PNS and the PNS cluster were determined with a raw p value of .05 (Chandler et al, 2016).…”

Oxytocin receptor DNA methylation is associated with exogenous oxytocin needs during parturition and postpartum hemorrhage

“…Oxytocin administration is the primary pharmacological intervention used during the course of labor 65 , 66 and is frequently used for labor induction 67 , rates of which have risen from 9.5% of births in 1990 68 to 31.4% of births in 2020 69 . Intrapartum dose requirements for oxytocin have been found to vary by body mass index (BMI) 70 , 71 and maternal age 72 , and may be influenced by differences in lipid metabolism 73 . While use of oxytocin for labor stimulation may be a life-saving intervention, overuse can expose the mother to risks, including postpartum hemorrhage 74 – 76 .…”