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Integrated trajectories of the maternal metabolome, proteome, and immunome predict labor onset
Science Translational Medicine
  • Ina A. Stelzer, Stanford University School of Medicine
  • Mohammad Sajjad Ghaemi, Stanford University School of Medicine
  • Xiaoyuan Han, University of the Pacific
  • Kazuo Ando, Stanford University School of Medicine
  • Julien J. Hédou, Stanford University School of Medicine
  • Dorien Feyaerts, Stanford University School of Medicine
  • Laura S. Peterson, Stanford University School of Medicine
  • Kristen K. Rumer, Stanford University School of Medicine
  • Eileen S. Tsai, Stanford University School of Medicine
  • Edward A. Ganio, Stanford University School of Medicine
  • Dyani K. Gaudillière, Stanford University School of Medicine
  • Amy S. Tsai, Stanford University School of Medicine
  • Benjamin Choisy, Stanford University School of Medicine
  • Lee P. Gaigne, Stanford University School of Medicine
  • Franck Verdonk, Stanford University School of Medicine
  • Danielle Jacobsen, Stanford University School of Medicine
  • Sonia Gavasso, Stanford University School of Medicine
  • Gavin M. Traber, Stanford University School of Medicine
  • Mathew Ellenberger, Stanford University School of Medicine
  • Natalie Stanley, Stanford University School of Medicine
  • Martin Becker, Stanford University School of Medicine
  • Anthony Culos, Stanford University School of Medicine
  • Ramin Fallahzadeh, Stanford University School of Medicine
  • Ronald J. Wong, Stanford University School of Medicine
  • Gary L. Darmstadt, Stanford University School of Medicine
  • Maurice L. Druzin, Stanford University School of Medicine
  • Virginia D. Winn, Stanford University School of Medicine
  • Ronald S. Gibbs, Stanford University School of Medicine
  • Xuefeng B. Ling, Stanford University School of Medicine
Department
Biomedical Sciences
Document Type
Article
DOI
10.1126/scitranslmed.abd9898
Publication Date
5-5-2021
Abstract

Estimating the time of delivery is of high clinical importance because pre- and postterm deviations are associated with complications for the mother and her offspring. However, current estimations are inaccurate. As pregnancy progresses toward labor, major transitions occur in fetomaternal immune, metabolic, and endocrine systems that culminate in birth. The comprehensive characterization of maternal biology that precedes labor is key to understanding these physiological transitions and identifying predictive biomarkers of delivery. Here, a longitudinal study was conducted in 63 women who went into labor spontaneously. More than 7000 plasma analytes and peripheral immune cell responses were analyzed using untargeted mass spectrometry, aptamer-based proteomic technology, and single-cell mass cytometry in serial blood samples collected during the last 100 days of pregnancy. The high-dimensional dataset was integrated into a multiomic model that predicted the time to spontaneous labor [R = 0.85, 95% confidence interval (CI) [0.79 to 0.89], P = 1.2 × 10−40, N = 53, training set; R = 0.81, 95% CI [0.61 to 0.91], P = 3.9 × 10−7, N = 10, independent test set]. Coordinated alterations in maternal metabolome, proteome, and immunome marked a molecular shift from pregnancy maintenance to prelabor biology 2 to 4 weeks before delivery. A surge in steroid hormone metabolites and interleukin-1 receptor type 4 that preceded labor coincided with a switch from immune activation to regulation of inflammatory responses. Our study lays the groundwork for developing blood-based methods for predicting the day of labor, anchored in mechanisms shared in preterm and term pregnancies.

Citation Information
Ina A. Stelzer, Mohammad Sajjad Ghaemi, Xiaoyuan Han, Kazuo Ando, et al.. "Integrated trajectories of the maternal metabolome, proteome, and immunome predict labor onset" Science Translational Medicine Vol. 13 Iss. 592 (2021) ISSN: 1946-6234
Available at: http://works.bepress.com/xiaoyuan-han/55/