Project Details

Metabolomic signatures associated with SDoH, preterm birth, and small-for-gestational age (MAPS)

Stephanie Fisher, MD, MPH

Summary

BACKGROUND: Birthing people exposed to chronic psychosocial stress and neighborhood deprivation experience higher rates of perinatal morbidity. However, we do not yet understand the biologic mechanisms that link these social determinants with two leading causes of perinatal morbidity, preterm birth (PTB) and small-for-gestational age (SGA). GAP: We thus lack effective screening biomarkers to risk stratify socially vulnerable pregnant people at highest risk of perinatal morbidity who would most benefit from heightened surveillance or other targeted risk-reducing interventions. Profiling metabolomic signatures across the maternal-placental-neonatal unit may thus identify translatable biomarkers to inform clinical management of socially vulnerable individuals at highest risk of PTB and SGA. HYPOTHESIS: We hypothesize greater psychosocial stress and neighborhood deprivation during pregnancy will explain variation in metabolomic signatures that reflect dysregulated patterns of maternal-placental-neonatal amino acid, lipid, and fatty acid metabolism in preterm and SGA neonates. METHODS: We have recruited a prospective cohort of 200 publicly-insured birthing parent-neonatal dyads who complete a series of validated survey instruments assessing psychosocial stress and neighborhood deprivation. We will conduct targeted metabolomic profiling on concurrently collected maternal plasma, placenta, cord blood biospecimens, and perform variance decomposition analyses to distinguish metabolite profiles that biologically link these social determinants with PTB and SGA. RESULTS: Pending. IMPACT: This translational research will generate high-quality mechanistic evidence for metabolic dysregulation that links SDoH with PTB and SGA. This work will lay the foundation for development of a future risk assessment score comprised of clinical, social, and metabolite profile data to discriminate socially disadvantaged pregnant people and neonates that may most benefit from personalized and/or public health interventions to mitigate morbidity. Website Link: https://sites.northwestern.edu/yeelab/metabolomic-signatures-associated-with-adverse-pregnancy-outcomes-and-social-determinants-of-health-mash/