Targeted newborn metabolomics: prediction of gestational age from cord blood

Abstract

Objective: Our study sought to determine whether metabolites from a retrospective collection of banked cord blood specimens could accurately estimate gestational age and to validate these findings in cord blood samples from Busia, Uganda.

Study design: Forty-seven metabolites were measured by tandem mass spectrometry or enzymatic assays from 942 banked cord blood samples. Multiple linear regression was performed, and the best model was used to predict gestational age, in weeks, for 150 newborns from Busia, Uganda.

Results: The model including metabolites and birthweight, predicted the gestational ages within 2 weeks for 76.7% of the Ugandan cohort. Importantly, this model estimated the prevalence of preterm birth <34 weeks closer to the actual prevalence (4.67% and 4.00%, respectively) than a model with only birthweight which overestimates the prevalence by 283%.

Conclusion: Models that include cord blood metabolites and birth weight appear to offer improvement in gestational age estimation over birth weight alone.

Figure 1:

Receiver operator curves of metabolic and birthweight models for identifying those born preterm (<37 completed weeks) vs those born term (≥37 weeks) in the Iowa (a) and Ugandan (b) cohorts. Curves for birthweight only model (dashed line), metabolites only model (dotted line), and birthweight plus metabolites model (solid line).