Abstract
Omics technologies hold great potential as the basis for development of the new diagnostic approaches in obstetrics. Cervicovaginal fluid (CVF) as part of the mother-placenta-fetus system can be used to diagnose obstetric complications. This study aimed to identify the features of lipid composition of the cervical canal secretion peculiar to Intrauterine Growth Restriction (IUGR) and preeclampsia (PE). We took CVF samples from 57 pregnant women and subjected them to an in-depth clinical-anamnestic and mass-spectrometric analysis. Lipid extracts of CVF were analyzed with a liquid chromatography system coupled with a mass analyzer. As a result, we identified 239 lipid compounds. In case of 17 lipids, mathematical analysis revealed significant differences between samples from women with normal pregnancy indicator values (normal group) and patients from the IUGR group (p < 0.05). As for the normal group and PE group patients, there were significant differences identified for 3 lipids (p < 0.05). Comparison of samples from the PE and IUGR groups yielded statistically significant differences in levels of two lipids (p < 0.05). Mainly, the lipids were oxylipins, sphingomyelins, triglycerides, and cardiolipins. The developed diagnostic model had the sensitivity of 0.81 and specificity of 0.91 (cut-off level — 0.50; AUC — 0.85). The data obtained are valuable in the context of development of the new methods of diagnosing placentaassociated complications of pregnancy and for understanding new mechanisms of pathogenesis of these complications.
Highlights
IntroductionI. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, for his help in organization of the study, systematic analysis and manuscript editing
Compliance with ethical standards: the study was approved by the ethical committee of Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology (Minutes #11 of November 11, 2021), conducted in accordance with the requirements of the Declaration of Helsinki, International Conference on Harmonization (ICH), Standards of Good Clinical Practice (GCP), Federal Law "On the Basics of Health Protection of Citizens in the Russian Federation"; all patients signed a voluntary informed consent to participate in the study
Group II inclusion criteria: Intrauterine Growth Restriction (IUGR) diagnosed through a ultrasound study, if there was a slowdown in the rate of increase of the estimated fetal weight (EFW) and/or abdominal circumference (AC) < 10th percentile, in combination with pathological blood flow as shown with Doppler ultrasonography or EFW and/or AC values < 3rd percentile
Summary
I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, for his help in organization of the study, systematic analysis and manuscript editing. Compliance with ethical standards: the study was approved by the ethical committee of Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology (Minutes #11 of November 11, 2021), conducted in accordance with the requirements of the Declaration of Helsinki, International Conference on Harmonization (ICH), Standards of Good Clinical Practice (GCP), Federal Law "On the Basics of Health Protection of Citizens in the Russian Federation"; all patients signed a voluntary informed consent to participate in the study. Математический анализ выявил значимые различия между пациентками группы нормы и c задержкой развития плода (ЗРП) для 17 липидов (р < 0,05). Между пациентками группы нормы и преэклампсии (ПЭ) значимые различия были обнаружены для трех липидов (р < 0,05). Между пациентками с ПЭ и пациентками с ЗРП статистически значимая разница в уровнях была выявлена для двух липидов (р < 0,05).
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