Noninvasive screening for congenital heart defects using a serum metabolomics approach

Author:

Troisi Jacopo123ORCID,Cavallo Pierpaolo45,Richards Sean67,Symes Steven78,Colucci Angelo1,Sarno Laura9ORCID,Landolfi Annamaria1,Scala Giovanni210,Adair David7,Ciccone Carla11,Maruotti Giuseppe M.9,Martinelli Pasquale9,Guida Maurizio129

Affiliation:

1. Department of Medicine and Surgery and Dentistry Scuola Medica Salernitana University of Salerno Salerno Italy

2. Metabolomics section Theoreo Srl – Spin‐off Company of the University of Salerno Salerno Italy

3. Metabolomics section European Biomedical Research Institute of Salerno (EBRIS) Salerno Italy

4. Department of Physics University of Salerno Salerno Italy

5. Istituto Sistemi Complessi Consiglio Nazionale delle Ricerche (CNR) Rome Italy

6. Department of Biology, Geology and Environmental Sciences University of Tennessee at Chattanooga Chattanooga Tennessee USA

7. Department of Obstetrics and Gynecology University of Tennessee College of Medicine Chattanooga TN USA

8. Department of Chemistry and Physics University of Tennessee at Chattanooga Chattanooga Tennessee USA

9. Department of Neurosciences and Reproductive and Dentistry Sciences University of Naples Federico II Naples Italy

10. Hosmotic Srl Naples Italy

11. Obstetrics and Gynecology clinic G. Moscati Hospital Avellino Italy

Abstract

AbstractObjectiveHeart anomalies represent nearly one‐third of all congenital anomalies. They are currently diagnosed using ultrasound. However, there is a strong need for a more accurate and less operator‐dependent screening method. Here we report a metabolomics characterization of maternal serum in order to describe a metabolomic fingerprint representative of heart congenital anomalies.MethodsMetabolomic profiles were obtained from serum of 350 mothers (280 controls and 70 cases). Nine classification models were built and optimized. An ensemble model was built based on the results from the individual models.ResultsThe ensemble machine learning model correctly classified all cases and controls. Malonic, 3‐hydroxybutyric and methyl glutaric acid, urea, androstenedione, fructose, tocopherol, leucine, and putrescine were determined as the most relevant metabolites in class separation.ConclusionThe metabolomic signature of second trimester maternal serum from pregnancies affected by a fetal heart anomaly is quantifiably different from that of a normal pregnancy. Maternal serum metabolomics is a promising tool for the accurate and sensitive screening of such congenital defects. Moreover, the revelation of the associated metabolites and their respective biochemical pathways allows a better understanding of the overall pathophysiology of affected pregnancies.

Publisher

Wiley

Reference78 articles.

1. Birth Prevalence of Congenital Heart Disease Worldwide

2. Isolated major congenital heart disease

3. Hospital stays, hospital charges, and in‐hospital deaths among infants with selected birth defects—United States, 2003;Centers for Disease Control and Prevention (CDC);MMWR Morb Mortal Wkly Rep,2007

4. Fetal heart defects: Potential and pitfalls of first-trimester detection

5. Contribution of Fetal Tricuspid Regurgitation in First-Trimester Screening for Major Cardiac Defects

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