Abstract:
Preterm birth is one of the Great Obstetric Syndromes and is a leading cause of neonatal mortality and morbidity and also increases the risk of developing chronic diseases in the later stages of life. Identification of those pregnant women at increased risk of spontaneous preterm birth (sPTB) at an early phase of pregnancy could aid in both prevention and management of sPTB. This thesis uses early pregnancy screening of metabolomics biomarkers to predict sPTB. Maternal serum, amniotic fluid, and cervicovaginal fluids were obtained and the metabolome was analysed to attain potential biomarkers. The metabolome obtained from women with healthy normal pregnancies was compared to that of pregnancies that resulted in a sPTB to characterise differential metabolite profiles and thereby develop a predictive panel which could have clinical utility for early detection of later pregnancy complications. There were significant differences observed at both 15 and 20 weeks of pregnancy. Maternal serum showed significant differences in sPTB cases at both 15 and 20 weeks of gestation. A significant proportion (42%) of biomarker compounds were found to be common to both 15 and 20 weeks, strengthening the possibility of obtaining early screening biomarkers for sPTB. Some of the potential biomarkers are endogenous, but a few are suspected to have an exogenous origin. A putative link between alkanes in maternal serum, sPTB and air pollution is evident from this study.
