ArticleBMC medicine2023
Metabolic dynamics and prediction of sFGR and adverse fetal outcomes: a prospective longitudinal cohort study.
Article in BMC medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.
- The search for blood biomarkers that indicate risk of adverse neurodevelopmental outcomes in fetal growth restriction.Frontiers in pediatrics · 2024Pooled it
- Metabolomic profiling reveals key metabolic pathway alterations in monochorionic diamniotic twins with selective intrauterine growth restriction.BMC pregnancy and childbirth · 2026Article
- Cord serum metabolic signatures associated with neonatal anthropometry and neurodevelopment through age two in twins.iScience · 2026Article
- Meconium metabolomic profiling dysregulation and neonatal brain injury in selective fetal growth restriction.BMC pregnancy and childbirth · 2026Article
- Branched Chain Amino Acid Metabolism in Developmental Brain Injury: Putative Mechanisms and Therapeutic Potential.Developmental neuroscience · 2026Review
- Article
- Challenges in Determining Chorionicity and Diagnosing Selective Fetal Growth Restriction in Multifetal Pregnancies with Suspected Twin-Twin Transfusion Syndrome: A Case Report.International medical case reports journal · 2025Article
- A predictive model for stunting among children under the age of three.Frontiers in pediatrics · 2024Article
- The predictive value of thromboelastography, routine blood indices, ultrasound parameters, and placental thickness in determining fetal outcome.American journal of translational research · 2024Article
Corrections and comments
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Authors and funding
11 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundSelective fetal growth restriction (sFGR) is an extreme complication that significantly increases the risk of perinatal mortality and long-term adverse neurological outcomes in offspring, affecting approximately 15% of monochorionic diamniotic (MCDA) twin pregnancies. The lack of longitudinal cohort studies hinders the early prediction and intervention of sFGR.
methodsWe constructed a prospective longitudinal cohort study of sFGR, and quantified 25 key metabolites in 337 samples from maternal plasma in the first, second, and third trimester and from cord plasma. In particular, our study examined fetal growth and brain injury data from ultrasonography and used the Ages and Stages Questionnaire-third edition subscale (ASQ-3) to evaluate the long-term neurocognitive behavioral development of infants aged 2-3 years. Furthermore, we correlated metabolite levels with ultrasound data, including physical development and brain injury indicators, and ASQ-3 data using Spearman's-based correlation tests. In addition, special combinations of differential metabolites were used to construct predictive models for the occurrence of sFGR and fetal brain injury.
resultsOur findings revealed various dynamic patterns for these metabolites during pregnancy and a maximum of differential metabolites between sFGR and MCDA in the second trimester (n = 8). The combination of L-phenylalanine, L-leucine, and L-isoleucine in the second trimester, which were closely related to fetal growth indicators, was highly predictive of sFGR occurrence (area under the curve [AUC]: 0.878). The combination of L-serine, L-histidine, and L-arginine in the first trimester and creatinine in the second trimester was correlated with long-term neurocognitive behavioral development and showed the capacity to identify fetal brain injury with high accuracy (AUC: 0.94).
conclusionsThe performance of maternal plasma metabolites from the first and second trimester is superior to those from the third trimester and cord plasma in discerning sFGR and fetal brain injury. These metabolites may serve as useful biomarkers for early prediction and promising targets for early intervention in clinical settings.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.