Carlson Nicole S, Frediani Jennifer K, Corwin Elizabeth J, Dunlop Anne, Jones Dean
Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, Georgia.
Department of Physiology, Columbia University School of Nursing, New York, New York.
AJP Rep. 2020 Jan;10(1):e68-e77. doi: 10.1055/s-0040-1702928. Epub 2020 Mar 4.
The purpose of this study was to evaluate the metabolic pathways activated in the serum of African-American women during late pregnancy that predicted term labor dystocia. Matched case-control study ( = 97; 48 cases of term labor dystocia and 49 normal labor progression controls) with selection based on body mass index (BMI) at hospital admission and maternal age. Late pregnancy serum samples were analyzed using ultra-high-resolution metabolomics. Differentially expressed metabolic features and pathways between cases experiencing term labor dystocia and normal labor controls were evaluated in the total sample, among women who were obese at the time of labor (BMI ≥ 30 kg/m2), and among women who were not obese. Labor dystocia was predicted by different metabolic pathways in late pregnancy serum among obese (androgen/estrogen biosynthesis) versus nonobese African-American women (fatty acid activation, steroid hormone biosynthesis, bile acid biosynthesis, glycosphingolipid metabolism). After adjusting for maternal BMI and age in the total sample, labor dystocia was predicted by tryptophan metabolic pathways in addition to C21 steroid hormone, glycosphingolipid, and androgen/estrogen metabolism. Metabolic pathways consistent with lipotoxicity, steroid hormone production, and tryptophan metabolism in late pregnancy serum were significantly associated with term labor dystocia in African-American women.
本研究的目的是评估妊娠晚期非裔美国女性血清中激活的代谢途径，这些途径可预测足月分娩难产。 采用匹配病例对照研究（n = 97；48例足月分娩难产病例和49例正常分娩进展对照），根据入院时的体重指数（BMI）和产妇年龄进行选择。使用超高分辨率代谢组学分析妊娠晚期血清样本。在总样本、分娩时肥胖的女性（BMI≥30 kg/m2）以及非肥胖女性中，评估足月分娩难产病例和正常分娩对照之间差异表达的代谢特征和途径。 肥胖（雄激素/雌激素生物合成）与非肥胖非裔美国女性（脂肪酸激活、类固醇激素生物合成、胆汁酸生物合成、糖鞘脂代谢）的妊娠晚期血清中，不同的代谢途径可预测分娩难产。在总样本中调整产妇BMI和年龄后，除C21类固醇激素、糖鞘脂和雄激素/雌激素代谢外，色氨酸代谢途径也可预测分娩难产。 妊娠晚期血清中与脂毒性、类固醇激素产生和色氨酸代谢一致的代谢途径，与非裔美国女性足月分娩难产显著相关。
