Spontaneous miscarriage in first trimester pregnancy is associated with altered urinary metabolite profile

Spontaneous miscarriage in first trimester pregnancy is associated with altered urinary metabolite profile
Title:
Spontaneous miscarriage in first trimester pregnancy is associated with altered urinary metabolite profile
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Publication Date:
19 August 2017
Citation:
Chee Wai Ku, Zhen Wei Tan, Mark Kit Lim, Zhi Yang Tam, Chih-Hsien Lin, Sean Pin Ng, John Carson Allen, Sze Min Lek, Thiam Chye Tan, Nguan Soon Tan, Spontaneous miscarriage in first trimester pregnancy is associated with altered urinary metabolite profile, BBA Clinical, Volume 8, 2017, Pages 48-55, ISSN 2214-6474, https://doi.org/10.1016/j.bbacli.2017.07.003. (http://www.sciencedirect.com/science/article/pii/S2214647417300302) Abstract: Threatened miscarriage is the most common gynecological emergency, occurring in about 20% of pregnant women. Approximately one in four of these patients go on to have spontaneous miscarriage and the etiology of miscarriage still remains elusive. In a bid to identify possible biomarkers and novel treatment targets, many studies have been undertaken to elucidate the pathways that lead to a miscarriage. Luteal phase deficiency has been shown to contribute to miscarriages, and the measurement of serum progesterone as a prognostic marker and the prescription of progesterone supplementation has been proposed as possible diagnostic and treatment methods. However, luteal phase deficiency only accounts for 35% of miscarriages. In order to understand the other causes of spontaneous miscarriage and possible novel urine biomarkers for miscarriage, we looked at the changes in urinary metabolites in women with threatened miscarriage. To this end, we performed a case-control study of eighty patients who presented with threatened miscarriage between 6 and 10weeks gestation. Urine metabolomics analyses of forty patients with spontaneous miscarriages and forty patients with ongoing pregnancies at 16weeks gestation point to an impaired placental mitochondrial β-oxidation of fatty acids as the possible cause of spontaneous miscarriage. This study also highlighted the potential of urine metabolites as a non-invasive screening tool for the risk stratification of women presenting with threatened miscarriage. Keywords: Carnitines; Mass spectrometry; Spontaneous miscarriage; Urine metabolites
Abstract:
Threatened miscarriage is the most common gynecological emergency, occurring in about 20% of pregnant women. Approximately one in four of these patients go on to have spontaneous miscarriage and the etiology of miscarriage still remains elusive. In a bid to identify possible biomarkers and novel treatment targets, many studies have been undertaken to elucidate the pathways that lead to a miscarriage. Luteal phase deficiency has been shown to contribute to miscarriages, and the measurement of serum progesterone as a prognostic marker and the prescription of progesterone supplementation has been proposed as possible diagnostic and treatment methods. However, luteal phase deficiency only accounts for 35% of miscarriages. In order to understand the other causes of spontaneous miscarriage and possible novel urine biomarkers for miscarriage, we looked at the changes in urinary metabolites in women with threatened miscarriage. To this end, we performed a case-control study of eighty patients who presented with threatened miscarriage between 6 and 10 weeks gestation. Urine metabolomics analyses of forty patients with spontaneous miscarriages and forty patients with ongoing pregnancies at 16 weeks gestation point to an impaired placental mitochondrial β-oxidation of fatty acids as the possible cause of spontaneous miscarriage. This study also highlighted the potential of urine metabolites as a non-invasive screening tool for the risk stratification of women presenting with threatened miscarriage.
License type:
http://creativecommons.org/licenses/by-nc-nd/4.0/
Funding Info:
All work in this manuscript was supported by the Ministry of Health -Singapore (MOHIAFCat1-11010) awarded to TCT. All authors reviewed the results and approved the final version of the manuscript. All authors declare no conflicts of interest regarding the content of this article.
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ISSN:
2211-2677
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