Murdoch Children's Research Institute, Parkville, VIC, Australia.
Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia.
Pediatr Res. 2022 Jun;91(7):1864-1873. doi: 10.1038/s41390-021-01672-7. Epub 2021 Sep 15.
Pathways towards many adult-onset conditions begin early in life, even in utero. Maternal health in pregnancy influences this process, but little is known how it affects neonatal metabolism. We investigated associations between pregnancy and birth factors and cord blood metabolomic profile in a large, population-derived cohort.
Metabolites were measured using nuclear magnetic resonance in maternal (28 weeks gestation) and cord serum from 912 mother-child pairs in the Barwon Infant Study pre-birth cohort. Associations between maternal (metabolites, age, BMI, smoking), pregnancy (pre-eclampsia, gestational diabetes (GDM)), and birth characteristics (delivery mode, gestational age, weight, infant sex) with 72 cord blood metabolites were examined by linear regression.
Delivery mode, sex, gestational age, and birth weight were associated with specific metabolite levels in cord blood, including amino acids, fatty acids, and cholesterols. GDM was associated with higher cord blood levels of acetoacetate and 3-hydroxybutyrate.
Neonatal factors, particularly delivery mode, were associated with many cord blood metabolite differences, including those implicated in later risk of cardiometabolic disease. Associations between GDM and higher offspring ketone levels at birth are consistent with maternal ketosis in diabetic pregnancies. Further work is needed to determine whether these neonatal metabolome differences associate with later health outcomes.
Variations in blood metabolomic profile have been linked to health status in adults and children, but corresponding data in neonates are scarce. We report evidence that pregnancy complications, mode of delivery, and offspring characteristics, including sex, are independently associated with a range of circulating metabolites at birth, including ketone bodies, amino acids, cholesterols, and inflammatory markers. Independent of birth weight, exposure to gestational diabetes is associated with higher cord blood ketone bodies and citrate. These findings suggest that pregnancy complications, mode of delivery, gestational age, and measures of growth influence metabolic pathways prior to birth, potentially impacting later health and development.
许多成年期疾病的发生途径早在生命早期就开始了，甚至在子宫内也是如此。孕妇在怀孕期间的健康状况会影响这一过程，但人们对其如何影响新生儿代谢知之甚少。我们在一个大型的人群衍生队列中研究了妊娠和分娩因素与脐带血代谢组特征之间的关系。
在 Barwon 婴儿研究产前队列中，对 912 对母婴（妊娠 28 周时）的脐带血清进行了基于核磁共振的代谢物测量。通过线性回归，研究了母体（代谢物、年龄、BMI、吸烟）、妊娠（先兆子痫、妊娠期糖尿病（GDM））和分娩特征（分娩方式、胎龄、体重、婴儿性别）与 72 种脐带血代谢物之间的关联。
分娩方式、性别、胎龄和出生体重与脐带血中特定代谢物水平有关，包括氨基酸、脂肪酸和胆固醇。GDM 与脐带血中更高的乙酰乙酸和 3-羟基丁酸水平有关。
新生儿因素，特别是分娩方式，与许多脐带血代谢物差异有关，包括那些与以后发生心血管代谢疾病风险有关的差异。GDM 与后代出生时更高的酮体水平之间的关联与糖尿病妊娠中的母体酮症一致。需要进一步研究这些新生儿代谢组差异是否与以后的健康结果相关。
血液代谢组特征的变化与成人和儿童的健康状况有关，但新生儿的相应数据很少。我们报告的证据表明，妊娠并发症、分娩方式以及包括性别在内的后代特征与出生时一系列循环代谢物有关，包括酮体、氨基酸、胆固醇和炎症标志物。与出生体重无关，暴露于妊娠期糖尿病与脐带血中更高的酮体和柠檬酸有关。这些发现表明，妊娠并发症、分娩方式、胎龄和生长指标会影响出生前的代谢途径，可能会影响以后的健康和发育。
