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CC BY-NC-ND 4.0 · AJP Rep 2020; 10(01): e68-e77
DOI: 10.1055/s-0040-1702928
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Metabolomic Pathways Predicting Labor Dystocia by Maternal Body Mass Index

Nicole S. Carlson 
1   Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, Georgia
,
Jennifer K. Frediani
1   Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, Georgia
,
Elizabeth J. Corwin
2   Department of Physiology, Columbia University School of Nursing, New York, New York
,
Anne Dunlop
3   Departments of Family and Preventive Medicine, Epidemiology, and Nursing, Emory University, Atlanta, Georgia
,
Dean Jones
4   Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, Emory University, Atlanta, Georgia
› Institutsangaben Funding Drs. Nicole Carlson and Jennifer Frediani were supported by grant number K01NR016984 from the National Institute of Nursing Research during manuscript production.
This manuscript was supported by funding from the National Institutes of Health National Institutes of Nursing Research (R01NR014800), the Office of the Director [3R01NR014800, UG3OD023318], the National Institute of Environmental Health Sciences (P50ES926071), and the US Environmental Protection Agency (83615301 Mod. 2).
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Publikationsverlauf

22. Juli 2019

20. Dezember 2019

Publikationsdatum:
04. März 2020 (online)

   Lizenzen und Reprints

Abstract

Objectives 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.

Study Design Matched case–control study (n = 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.

Results 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.

Conclusion 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.

Keywords

labor dystocia - obesity - mechanisms - metabolomics - parturition

Declaration of Conflicting Interests per International Committee of Medical Journal Editors Guidelines

The authors declare that there is no conflict of interest.


Supplementary Material

 

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