Imagine being able to tell whether your baby will be premature or suffer poor growth during the early stages of pregnancy by providing just a urine sample. Researchers from Imperial College London collaborated with some from the University of Crete and published their findings of an important molecule in the journal of BMC Medicine.

“Our findings imply that it could be possible to improve the identification of women at higher risk of delivering smaller babies or premature delivery using non-invasive metabolic profiling technology early in pregnancy," said the study's co-author Hector Keun, from the Department of Surgery and Cancer at Imperial College London, in a press release.

Researchers analyzed the urine samples of 438 pregnant women and focused on their metabolites, the small molecules in urine to see what it could tell them. They examined results from the Rhea cohort, a large mother-child population that was studied in Crete in 2007. They used the urine sample data that was collected at the first ultrasound appointment.

"While we know that metabolism in the mother changes substantially during pregnancy to help supply the growing fetus with nutrients, we were surprised to see so early in pregnancy a link between metabolites that we could easily detect in a urine sample and low birthweight,” Keun said.

Women who had elevated levels of the amino acid lysine were found to have a higher risk of spontaneous premature birth. In addition, the researchers found that increased levels of N-acetylated glycoprotein also induced an early labor. Meanwhile, when a pregnant woman’s acetate, formate tyrosine, and trimethylamine were lower than normal, their babies had poor fetal development.

"Future investigation of the factors that produce the molecules associated with these pregnancy outcomes should improve our understanding of the genetic and environmental factors that influence restricted fetal growth, and thus help us to reduce the likelihood of these events. We will also go on to test if exposure to these metabolites during pregnancy has a lasting impact on child development after birth," Keun said.

Premature birth and fetal growth problems increase the risk of developing metabolic and cardiovascular disorders later in the baby’s life. According to the Centers for Disease Control and Prevention, every year, 500,000 babies are delivered preterm, which is one for every eight infants. Preterm-related deaths accounted for 35 percent of all infant deaths in 2009, which is more than any one cause of death.

The urinary levels need to be further investigated in order for doctors to start using urine samples as a preliminary caution procedure. Considering that preterm birth costs add up to more than $26 billion in the United States alone, any type of early detection procedure needs to be further investigated.

Source: Keun HC, Kogevinas M, Chatzi L, et al. Urinary metabolic profiles in early pregnancy are associated with preterm birth and fetal growth restriction in the Rhea mother–child cohort study. BMC Medicine. 2014.