News Release

Non-invasive test could be used to predict premature birth and delivery of small babies

Peer-Reviewed Publication

Imperial College London

Testing for the presence of specific molecules present in the urine of pregnant women can give an indication in early pregnancy of whether a baby will be born premature or the fetus will suffer poor growth, according to research published in the open access journal BMC Medicine. Identifying these conditions early in pregnancy could potentially help reduce complications and manage any difficulties, although more work is needed before the findings can be translated to clinical settings.

Researchers from Imperial College London and the University of Crete analyzed the metabolites - small molecules excreted in urine - of 438 pregnant women in the Rhea cohort. They found that elevated urinary levels of the amino acid lysine were associated with spontaneous premature birth. In contrast, increased levels of a N-acetylated glycoprotein – a molecule consisting of a carbohydrate and a protein - tended to be found in women who had to be induced early. Decreased levels of a third group of molecules: acetate, formate, tyrosine and trimethylamine were associated with poor fetal development. Women with decreased levels of these urine metabolites also showed signs of an increased risk of diabetes, such as higher blood insulin.

The Rhea cohort is a large population case-control mother-child study that started in Crete in 2007. Urine samples were collected early in pregnancy at the first ultrasound appointment. Preterm birth and fetal growth restriction has been shown to increase the chance of developing metabolic and cardiovascular disorders later in life.

Hector Keun, lead researcher from the Department of Surgery and Cancer at Imperial College London, says: "While we know that metabolism in the mother changes substantially during pregnancy to help supply the growing fetus with nutrients, we were surprised to see so early in pregnancy a link between metabolites that we could easily detect in a urine sample and low birthweight. Our findings imply that it could be possible to improve the identification of women at higher risk of delivering smaller babies or premature delivery using non-invasive metabolic profiling technology early in pregnancy."

Further research needs to focus on whether changes in these metabolites are induced by pregnancy or indicate an underlying risk factor. It also remains to be seen if these results can be applied to a wider population and more research is needed before any such test could be used in practice.

Hector Keun says: "Future investigation of the factors that produce the molecules associated with these pregnancy outcomes should improve our understanding of the genetic and environmental factors that influence restricted fetal growth and thus help us to reduce the likelihood of these events. We will also go on to test if exposure to these metabolites during pregnancy has a lasting impact on child development after birth."

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For more information please contact:

Franca Davenport or Sam Wong
Research Media Officer
Imperial College London
Email: f.davenport@imperial.ac.uk
Tel: +44(0)20 7594 3415 / +44 (0) 207 594 2198
Out of hours duty press officer: +44(0)7803 886 248

Notes to editor:

1. Research article

Urinary metabolic profiles in early pregnancy are associated with preterm birth and fetal growth restriction in the Rhea mother-child cohort study Léa Maitre, Eleni Fthenou, Toby Athersuch, Muireann Coen, Mireille B Toledano, Elaine Holmes, Manolis Kogevinas, Leda Chatzi and Hector C Keun BMC Medicine 2014, 12:110. After embargo, article available at journal website here:

http://www.biomedcentral.com/1741-7015/12/110

2. BMC Medicine is the flagship medical journal of the BMC series, publishing original research, commentaries and reviews that are either of significant interest to all areas of medicine and clinical practice, or provide key translational or clinical advances in a specific field.

3. Consistently rated amongst the world's best universities, Imperial College London is a science-based institution with a reputation for excellence in teaching and research that attracts 14,000 students and 6,000 staff of the highest international quality. Innovative research at the College explores the interface between science, medicine, engineering and business, delivering practical solutions that improve quality of life and the environment - underpinned by a dynamic enterprise culture.

Since its foundation in 1907, Imperial's contributions to society have included the discovery of penicillin, the development of holography and the foundations of fibre optics. This commitment to the application of research for the benefit of all continues today, with current focuses including interdisciplinary collaborations to improve global health, tackle climate change, develop sustainable sources of energy and address security challenges.

In 2007, Imperial College London and Imperial College Healthcare NHS Trust formed the UK's first Academic Health Science Centre. This unique partnership aims to improve the quality of life of patients and populations by taking new discoveries and translating them into new therapies as quickly as possible. http://www.imperial.ac.uk

4. BioMed Central is an STM (Science, Technology and Medicine) publisher which has pioneered the open access publishing model. All peer-reviewed research articles published by BioMed Central are made immediately and freely accessible online, and are licensed to allow redistribution and reuse. BioMed Central is part of Springer Science+Business Media, a leading global publisher in the STM sector. http://www.biomedcentral.com


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