Utilizing Amniotic Fluid Metabolomics to Monitor Fetal Well-Being: A Narrative Review of the Literature

Kolvatzis, Charalampos; Tsakiridis, Ioannis; Kalogiannidis, Ioannis A; Tsakoumaki, Foteini; Kyrkou, Charikleia; Dagklis, Themistoklis; Daniilidis, Angelos; Michaelidou, Alexandra-Maria; Athanasiadis, Apostolos

doi:10.7759/cureus.36986

Cited by 4 publications

(7 citation statements)

References 75 publications

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“…Moreover, the reduced feature space (n = 94) was subjected to biomarker analysis considering the area under the ROC curve (AUROC) and the p values promoting potential biomarkers with a good predictive ability and strong statistical significance (AUROC > 0.75 and p < 0.05). These values are in accordance with the literature [10,20].…”

Section: Data Reduction Methods For Unique Potential Biomarker Discoverysupporting

confidence: 93%

“…Our study supports the hypothesis that PTD is characterized by several changes in the metabolic profile of the fetus as reflected in second-trimester amniotic fluid [10]. The multivariate analysis highlighted that dimethylglycine, glucose, myo-inositol and succinate possessed the highest discriminative ability between the two studied groups.…”

Section: Discussionsupporting

confidence: 87%

“…Prediction and early diagnosis of PTD are often challenging because of their complexity [4]. Hence, it is not surprising that metabolomics, utilizing advanced techniques such as Nuclear Magnetic Resonance Spectroscopy (NMR), Gas Chromatography-Mass Spectrometry (GC-MS), and Liquid Chromatography-Mass Spectrometry (LC-MS/MS), have gained prominence in identifying biomarkers and pathways crucial to the development and progression of this syndrome [4][5][6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

“…Studies in this area have employed diverse metabolomics techniques, and the consensus on critical metabolites serving as biomarkers remains elusive [10]. The apparent inconsistency highlights the intricate nature of the PTD syndrome and implies the presence of unexplored aspects.…”

Section: Introductionmentioning

confidence: 99%

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Metabolomic Profiling of Second-Trimester Amniotic Fluid for Predicting Preterm Delivery: Insights from NMR Analysis

Kolvatzis,

Christodoulou,

Kalogiannidis

et al. 2023

Metabolites

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Preterm delivery (PTD) is a notable pregnancy complication, affecting one out of every ten births. This study set out to investigate whether analyzing the metabolic composition of amniotic fluid (AF) collected from pregnant women during the second trimester of pregnancy could offer valuable insights into prematurity. The research employed 1H–NMR metabolomics to examine AF samples obtained from 17 women who gave birth prematurely (between 29+0 and 36+5 weeks of gestation) and 43 women who delivered at full term. The application of multivariate analysis revealed metabolites (dimethylglycine, glucose, myo-inositol, and succinate) that can serve as possible biomarkers for the prognosis and early diagnosis of preterm delivery. Additionally, pathway analysis unveiled the most critical metabolic pathways relevant to our research hypothesis. In summary, these findings suggest that the metabolic composition of AF in the second trimester can be a potential indicator for identifying biomarkers associated with the risk of PTD.

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Section: Data Reduction Methods For Unique Potential Biomarker Discoverysupporting

confidence: 93%

Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Metabolomic Profiling of Second-Trimester Amniotic Fluid for Predicting Preterm Delivery: Insights from NMR Analysis

Kolvatzis,

Christodoulou,

Kalogiannidis

et al. 2023

Metabolites

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“…7,8 In the past few decades, advances in metabolomics, ultrasound, and Doppler have elucidated several mechanisms in the pathophysiology and evolution of this disease; however, FGR remains a complex obstetric problem with low detection rate, indefinite diagnostic criteria, and limited preventive and treatment options available. 9,10 Thus, the development and implementation of consistent international evidence-based algorithms for the early detection, the optimal antenatal surveillance, and management of growth-restricted fetuses, as well as effective prevention, seem of pivotal importance and will hopefully lower not only their incidence, but also the associated fetal and neonatal morbidity and mortality. Hence, the aim of this descriptive review was to synthesize and compare recommendations from influential guidelines on the management of FGR.…”

mentioning

confidence: 99%

Fetal Growth Restriction: A Comprehensive Review of Major Guidelines

Giouleka,

Tsakiridis,

Mamopoulos

et al. 2023

Obstetrical &Amp; Gynecological Survey

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Importance Fetal growth restriction (FGR) is a common pregnancy complication and a significant contributor of fetal and neonatal morbidity and mortality, mainly due to the lack of effective screening, prevention, and management policies. Objective The aim of this study was to review and compare the most recently published influential guidelines on the management of pregnancies complicated by FGR. Evidence Acquisition A descriptive review of guidelines from the American College of Obstetricians and Gynecologists (ACOG), the Society for Maternal-Fetal Medicine, the International Federation of Gynecology and Obstetrics, the International Society of Ultrasound in Obstetrics and Gynecology, the Royal College of Obstetricians and Gynecologists, the Society of Obstetricians and Gynecologists of Canada (SOGC), the Perinatal Society of Australia and New Zealand, the Royal College of Physicians of Ireland, the French College of Gynecologists and Obstetricians (FCGO), and the German Society of Gynecology and Obstetrics on FGR was carried out. Results Several discrepancies were identified regarding the definition of FGR and small-for-gestational-age fetuses, the diagnostic criteria, and the need of testing for congenital infections. On the contrary, there is an overall agreement among the reviewed guidelines regarding the importance of early universal risk stratification for FGR to accordingly modify the surveillance protocols. Low-risk pregnancies should unanimously be evaluated by serial symphysis fundal height measurement, whereas the high-risk ones warrant increased sonographic surveillance. Following FGR diagnosis, all medical societies agree that umbilical artery Doppler assessment is required to further guide management, whereas amniotic fluid volume evaluation is also recommended by the ACOG, the SOGC, the Perinatal Society of Australia and New Zealand, the FCGO, and the German Society of Gynecology and Obstetrics. In case of early, severe FGR or FGR accompanied by structural abnormalities, the ACOG, the Society for Maternal-Fetal Medicine, the International Federation of Gynecology and Obstetrics, the Royal College of Obstetricians and Gynecologists, the SOGC, and the FCGO support the performance of prenatal diagnostic testing. Consistent protocols also exist on the optimal timing and mode of delivery, the importance of continuous fetal heart rate monitoring during labor, and the need for histopathological examination of the placenta after delivery. On the other hand, guidelines concerning the frequency of fetal growth and Doppler velocimetry evaluation lack uniformity, although most of the reviewed medical societies recommend an average interval of 2 weeks, reduced to weekly or less when umbilical artery abnormalities are detected. Moreover, there is a discrepancy on the appropriate timing for corticosteroids and magnesium sulfate administration, as well as the administration of aspirin as a preventive measure. Cessation of smoking, alcohol consumption, and illicit drug use are proposed as preventive measures to reduce the incidence of FGR. Conclusions Fetal growth restriction is a clinical entity associated with numerous adverse antenatal and postnatal events, but currently, it has no definitive cure apart from delivery. Thus, the development of uniform international protocols for the early recognition, the adequate surveillance, and the optimal management of growth-restricted fetuses seem of paramount importance to safely guide clinical practice, thereby improving perinatal outcomes of such pregnancies. Target Audience Obstetricians and gynecologists, family physicians. Learning Objectives After participating in this activity, the learner should be better able to define fetal growth restriction; describe screening and preventive recommendations for fetal growth restriction; and explain antenatal and intrapartum management options for pregnancies complicated by fetal growth restriction.

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Stratification of Amniotic Fluid Cells and Amniotic Fluid by Sex Opens Up New Perspectives on Fetal Health

Campesi,

Capobianco,

Cano

et al. 2023

Biomedicines

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Amniotic fluid is essential for fetus wellbeing and is used to monitor pregnancy and predict fetal outcomes. Sex affects health and medicine from the beginning of life, but knowledge of its influence on cell-depleted amniotic fluid (AF) and amniotic fluid cells (AFCs) is still neglected. We evaluated sex-related differences in AF and in AFCs to extend personalized medicine to prenatal life. AFCs and AF were obtained from healthy Caucasian pregnant women who underwent amniocentesis at the 16th–18th week of gestation for advanced maternal age. In the AF, inflammation biomarkers (TNFα, IL6, IL8, and IL4), malondialdehyde, nitrites, amino acids, and acylcarnitines were measured. Estrogen receptors and cell fate (autophagy, apoptosis, senescence) were measured in AFCs. TNFα, IL8, and IL4 were higher in female AF, whereas IL6, nitrites, and MDA were similar. Valine was higher in male AF, whereas several acylcarnitines were sexually different, suggesting a mitochondrial involvement in establishing sex differences. Female AFCs displayed higher expression of ERα protein and a higher ERα/ERβ ratio. The ratio of LC3II/I, an index of autophagy, was higher in female AFCs, while LC3 gene was similar in both sexes. No significant sex differences were found in the expression of the lysosomal protein LAMP1, while p62 was higher in male AFCs. LAMP1 gene was upregulated in male AFCs, while p62 gene was upregulated in female ones. Finally, caspase 9 activity and senescence linked to telomeres were higher in female AFCs, while caspase 3 and β-galactosidase activities were similar. This study supports the idea that sex differences start very early in prenatal life and influence specific parameters, suggesting that it may be relevant to appreciate sex differences to cover knowledge gaps. This might lead to improving the diagnosis of risk prediction for pregnancy complications and achieving a more satisfactory monitoring of fetus health, even preventing future diseases in adulthood.

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Utilizing Amniotic Fluid Metabolomics to Monitor Fetal Well-Being: A Narrative Review of the Literature

Cited by 4 publications

References 75 publications

Metabolomic Profiling of Second-Trimester Amniotic Fluid for Predicting Preterm Delivery: Insights from NMR Analysis

Metabolomic Profiling of Second-Trimester Amniotic Fluid for Predicting Preterm Delivery: Insights from NMR Analysis

Fetal Growth Restriction: A Comprehensive Review of Major Guidelines

Stratification of Amniotic Fluid Cells and Amniotic Fluid by Sex Opens Up New Perspectives on Fetal Health

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