pi is 0002937815003336

776.e1 American Journal of Obstetrics & Gynecology JUNE 2015 P Research ajog.org OBSTETRICS Women with preterm birth have a distinct cervicovaginal metabolome Jeny Ghartey, DO, MS; Jamie A. Bastek, MD, MSCE; Amy G. Brown, PhD; Laura Anglim, BA; Michal A. Elovitz, MD OBJECTIVE: Metabolomics has the potential to reveal novel pathways involved in the pathogenesis of preterm birth (PTB). The objective of this study was to investigate whether the cervicovaginal (CV ) metabolome was different in asymptomatic women destined to have a PTB compared with term birth. STUDY DESIGN: A nested case-control study was performed using CV fluid collected from a larger prospective cohort. The CV fluid was collected between 20-24 weeks (V1) and 24- 28 weeks (V2). The metabolome was compared between women with a spontaneous PTB (n ¼ 10) to women who delivered at term (n ¼ 10). Samples were extracted and prepared for analysis using a standard extraction solvent method. Global biochemical profiles were determined using gas chromatography/mass spectrometry and ultra-performance liquid chromatography/tandem mass spectrometry. An ANOVA was used to detect differences in biochemical compounds between the groups. A false discovery rate was estimated to account for multiple comparisons. RESULTS: A total of 313 biochemicals were identified in CV fluid. Eighty-two biochemicals were different in the CV fluid at V1 in those destined to have a PTB compared with term birth, whereas 48 were different at V2. Amino acid, carbohydrate, and peptide metabolites were distinct between women with and without PTB. CONCLUSION: These data suggest that the CV space is metabolically active during pregnancy. Changes in the CV metabolome may be observed weeks, if not months, prior to any clinical symptoms. Un- derstanding the CV metabolome may hold promise for unraveling the pathogenesis of PTB and may provide novel biomarkers to identify women most at risk. Key words: cervicovaginal metabolome, pregnancy, preterm birth Cite this article as: Ghartey J, Bastek JA, Brown AG, et al. Women with preterm birth have a distinct cervicovaginal metabolome. Am J Obstet Gynecol 2015;212:776.e1-12. reterm birth (PTB) is among the leading cause of neonatal morbidity and mortality, accounting for 11.2% of live births in the United States as of From the Maternal-Child Health Research Program, Department of Obstetrics and Gynecology, Perelman School of Medicine,

pi is 0002937815003336

Documents

e grou

t obioc

reterm birt

y astoinestigate

in6 flui

aginal metabolome jeny

sbet eent

eu47 atotal ofb1bbioc