Elemental nutrition is associated with a range of perinatal outcomes. Fetal outcomes such as birth weight, head circumference, placental weight, and preterm birth have all been associated with proper infant growth and development, the ability to identify risk factors early is vitally important. This project aims to apply elemental metabolomics in plasma and urine to identify relationships between elemental concentrations and pregnancy risk factors, using this information to determine gestational outcomes.
Plasma and urine samples were obtained from a cohort of 18-week pregnant women from the Lyell McEwin Hospital (Adelaide, Australia). Inductively coupled plasma mass spectrometry was used to measure 29 elements in plasma and urine from 117 patients (69 control, 48 complicated).
Male offspring were found to have higher concentrations of magnesium and strontium in plasma compared to females (5.3% and 10.1% respectively). Babies with birth weights in the lowest quartile had significantly lower urinary titanium, cobalt, copper, and plasma molybdenum than the middle 50th percentile (21.1 - 46.0%). Smaller head circumference was associated with lower cobalt, strontium, lead, and plasma barium (28.9 - 55.7%). Placental weight, small for gestational age (SGA), and preterm birth were able to be predicted at 18 weeks using a combination of elements and analysed by receiver operating characteristic curves. Increased selenium and molybdenum in plasma predicted a placenta under 500 g with 89% accuracy. Babies born SGA were identified 88% of the time using the ratio of copper to strontium in plasma. In 80% of cases, urine thallium and iodine could distinguish preterm birth from term pregnancies.
This study is the first to apply elemental metabolomics early in gestation to predict birth outcomes. This approach could be applied as an early predictor of specific gestational outcomes and provide insight into the mechanisms that drive these complex disorders.