Ciborowski Michal, Zbucka-Kretowska Monika, Bomba-Opon Dorota, Wielgos Miroslaw, Brawura-Biskupski-Samaha Robert, Pierzynski Piotr, Szmitkowski Maciej, Wolczynski Slawomir, Lipinska Danuta, Citko Anna, Bauer Witold, Gorska Maria, Kretowski Adam
Clinical Research Centre, Medical University of Bialystok, Poland.
Prenat Diagn. 2014 Sep;34(9):870-7. doi: 10.1002/pd.4386. Epub 2014 May 15.
Macrosomia and low birth weight (LBW) can be associated with pregnancy complications and may affect the long-term health of the child. The aim of this study was to evaluate the metabolomic serum profiles of healthy pregnant women to identify early biomarkers of macrosomia and LBW and to understand mechanisms leading to abnormal fetal growth not related to mother's body mass index or presence of gestational diabetes.
Serum samples from 770 women were collected between the 12th and 14th gestational week. Delivery samples were divided into three groups according to the infant birth weight as follows: low, <2500 g; normal, 2500-4000 g; and high >4000 g. Samples from women with any complications of pregnancy were excluded. Serum fingerprinting was performed by LC-QTOF-MS.
Lower levels of phospholipids, lysophospholipids, and monoacylglycerols; low vitamin D3 metabolites; and increased bilirubin level were associated with macrosomia. Because most changes involved lipids, as a concept of validation, adipocyte fatty acid-binding protein (A-FABP) levels were measured and found correlated with the studied lipids and birth weight.
Serum fingerprinting in early pregnancy can predict the risk of macrosomia. Serum levels of A-FABP and several lipids are promising prognostic markers for macrosomia in healthy pregnancies.
巨大儿和低出生体重（LBW）可能与妊娠并发症相关，并可能影响儿童的长期健康。本研究的目的是评估健康孕妇的代谢组血清谱，以识别巨大儿和低出生体重的早期生物标志物，并了解导致胎儿生长异常的机制，这些机制与母亲的体重指数或妊娠期糖尿病的存在无关。
在妊娠第12至14周期间收集了770名女性的血清样本。分娩样本根据婴儿出生体重分为三组，如下：低体重，<2500 g；正常体重，2500 - 4000 g；高体重，>4000 g。排除有任何妊娠并发症的女性的样本。通过液相色谱-四极杆飞行时间质谱（LC-QTOF-MS）进行血清指纹图谱分析。
磷脂、溶血磷脂和单酰甘油水平较低；维生素D3代谢物水平较低；胆红素水平升高与巨大儿有关。由于大多数变化涉及脂质，作为验证的一个概念，测量了脂肪细胞脂肪酸结合蛋白（A-FABP）水平，发现其与所研究的脂质和出生体重相关。
孕早期的血清指纹图谱可以预测巨大儿的风险。A-FABP和几种脂质的血清水平是健康妊娠中巨大儿的有前景的预后标志物。
