Application of Proteomics in Maternal and Neonatal Health: Advancements and Future Directions

Abstract

Maternal and neonatal health (women during pregnancy, childbirth, and the postnatal period) presents a spectrum of healthcare challenges, including preterm birth, preeclampsia, intrauterine growth restriction, polycystic ovarian syndrome, and gestational diabetes mellitus. While genomic investigations have shed light on many of these topics, protein biomarker discovery, a pivotal aspect of such research, holds promise in offering insights into disease diagnosis, progression, and prognosis. This review paper aims to explore the landscape of proteomics research pertaining to the aforementioned disorders. In the search for viable biomarkers, existing ones are either outdated or lack specificity and new ones being investigated do not commonly make it to the validation stage. In this review, the reasons for the gap between the biomarker discovery stage and the clinical validation stage are evaluated, in addition to what steps are being taken to mitigate the unexpectedly slow scientific and clinical progress. Notably, this paper also delves into the ethnic disparities found in maternal and neonatal health research, as well as how AI is currently being used to alleviate socioeconomic and ethnic disparities, as well as its advantages for the analysis of large "omics" datasets. We anticipate this investigation will provide critical, invaluable information for researchers, medical professionals, and policy decision-makers in this field to improve overall maternal and neonatal health outcomes.

Keywords: AI; biomarker discovery; biomarkers; clinical validation; ethnic populations; maternal health; neonatal health; preterm birth; proteomics; racial disparity.

FIGURE 1

Global and regional incidence of PTB. Graph recreated using a logarithmic scale to showcase data from the supplementary section table “Estimated numbers of subgroups of preterm babies by region” in 2020 by Ohuma et al. [5]. Additionally, GCC statistics are the mean of both Saudi Arabia and Qatar's PTB data [8, 14]. Data from Saudi Arabia ranges from November 2013 to March 2015 in Riyadh. Data from Qatar ranges from April 2017 to March 2018. To note, Qatar's data on the categories <28 weeks and 28 to <32 weeks was unavailable; hence, <28 weeks is only indicative of Saudi Arabian rates of PTB.

FIGURE 2

Conceptual framework of key issues and innovations in maternal and neonatal health. This conceptual flowchart highlights and breaks down the current landscape of obstetric biomarker research, the foundational issues, and the largest contributors to high rates of maternal and neonatal mortality and morbidity, as well as potential pathways to mitigate the existing gap between experimental research, clinical validation, and commercial access.

FIGURE 3

Advantages of biomarker discovery. Biomarker testing is compared to traditional screening methods, showing that biomarker discovery leads to higher rates of diagnosis, which further leads to treatment plans being made early and allowing for a better prognosis. Alternatively, traditional testing can lead to disorders potentially being left undiagnosed or can postpone intervention and lead to a poor prognosis.

FIGURE 4

Potentially relevant biomarkers in preterm birth, preeclampsia, intrauterine growth restriction, polycystic ovary syndrome, and gestational diabetes. Biomarkers most recurring in literature searches are listed in line with the disorders they can aid in diagnosing, predicting progress, and evaluating prognosis. To note, some proteins are repeated and can be used to predict the onset of several disorders.