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Elemental Metabolomics for Prediction of Term Gestational Outcomes Utilising 18-Week Maternal Plasma and Urine Samples

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Abstract

A normal pregnancy is essential to establishing a healthy start to life. Complications during have been associated with adverse perinatal outcomes and lifelong health problems. The ability to identify risk factors associated with pregnancy complications early in gestation is vitally important for preventing negative foetal outcomes. Maternal nutrition has been long considered vital to a healthy pregnancy, with micronutrients and trace elements heavily implicated in maternofoetal metabolism. This study proposed the use of elemental metabolomics to study multiple elements at 18 weeks gestation from blood plasma and urine to construct models that could predict outcomes such as small for gestational age (SGA) (n = 10), low placental weight (n = 18), and preterm birth (n = 13) from control samples (n = 87). Samples collected from the Lyell McEwin Hospital in Adelaide, South Australia, were measured for 27 plasma elements and 37 urine elements by inductively coupled plasma mass spectrometry. Exploratory analysis indicated an average selenium concentration 20 μg/L lower than established reference ranges across all groups, low zinc in preterm (0.64 μg/L, reference range 0.66–1.10 μg/L), and higher iodine in preterm and SGA gestations (preterm 102 μg/L, SGA 111 μg/L, reference range 40–92 μg/L). Using random forest algorithms with receiver operating characteristic curves, low placental weight was predicted with 86.7% accuracy using plasma, 78.6% prediction for SGA with urine, and 73.5% determination of preterm pregnancies. This study indicates that elemental metabolomic modelling could provide a means of early detection of at-risk pregnancies allowing for more targeted monitoring of mothers, with potential for early intervention strategies to be developed.

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Acknowledgements

The authors would like to thank the Lyell McEwin team for providing access to the data and biological samples and acknowledge the contribution made by the mothers and families who took part in this study.

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Authors and Affiliations

  1. School of Medical Science, Griffith University, Gold Coast Campus, Parklands Drive, Southport, QLD, 4215, Australia

    Daniel R. McKeating, Joshua J. Fisher & Anthony V. Perkins

  2. Pregnancy and Development, Mater Research Institute-University of Queensland, Translational Research Institute, South Brisbane, Australia

    Vicki L. Clifton

  3. QIMR Berghofer Medical Research Institute, Herston, QLD, Australia

    Cameron P. Hurst

  4. School of Environment and Science, Griffith University, Gold Coast Campus, Southport, Queensland, Australia

    William W. Bennett

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  1. Daniel R. McKeating
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  2. Vicki L. Clifton
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  3. Cameron P. Hurst
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  4. Joshua J. Fisher
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  6. Anthony V. Perkins
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Correspondence to Anthony V. Perkins.

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McKeating, D.R., Clifton, V.L., Hurst, C.P. et al. Elemental Metabolomics for Prediction of Term Gestational Outcomes Utilising 18-Week Maternal Plasma and Urine Samples. Biol Trace Elem Res 199, 26–40 (2021). https://doi.org/10.1007/s12011-020-02127-6

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  • DOI: https://doi.org/10.1007/s12011-020-02127-6

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