Second trimester short cervix is associated with decreased abundance of cervicovaginal lipid metabolites - 20/07/22
, Nancy Yang, BA a, Lauren Anton, PhD a, Maayan Levy, PhD b, Jacques Ravel, PhD c, Michal A. Elovitz, MD a, b, Heather H. Burris, MD, MPH a, dAbstract |
Background |
A short cervix is a risk factor for preterm birth. The molecular drivers of a short cervix remain elusive. Metabolites may function as mediators of pathologic processes.
Objective |
We sought to determine if a distinct cervicovaginal metabolomic profile is associated with a short cervix (<25 mm) to unveil the potential mechanisms by which premature cervical remodeling leads to a short cervix.
Study Design |
This was a secondary analysis of a completed prospective pregnancy cohort. Cervicovaginal fluid was obtained between 20 and 24 weeks’ gestation. The participants selected for metabolomic profiling were frequency-matched by birth outcome and cervicovaginal microbiota profile. This analysis included 222 participants with cervical length measured. A short cervix was defined as one having length <25 mm, as measured by transvaginal ultrasound. Unpaired t-tests were performed with a Bonferroni correction for multiple comparisons.
Results |
There were 27 participants with a short cervix, and 195 with normal cervical length. Of the 637 metabolites detected, 26 differed between those with a short cervix and those with normal cervical lengths; 22 were decreased, of which 21 belonged to the lipid metabolism pathway (all P<.000079). Diethanolamine, erythritol, progesterone, and mannitol or sorbitol were increased in the cases of short cervix. Among participants with Lactobacillus-deficient microbiota, only diethanolamine and mannitol or sorbitol differed between short cervix (n=17) and normal cervical length (n=75), both increased.
Conclusion |
A short cervix is associated with decreased cervicovaginal lipid metabolites, particularly sphingolipids. This class of lipids stabilizes cell membranes and protects against environmental exposures. Increased diethanolamine—an immunostimulatory xenobiotic—is associated with a short cervix. These observations begin to identify the potential mechanisms by which modifiable environmental factors may invoke cell damage in the setting of biological vulnerability, thus promoting premature cervical remodeling in spontaneous preterm birth.
Le texte complet de cet article est disponible en PDF.Key words : metabolites, metabolome, microbiome, short cervix, spontaneous preterm birth
Plan
| M.A.E. receives salary support from the National Institutes of Health (NIH; The National Institute of Nursing Research, National Institute of Allergy and Infectious Disease, and Eunice Kennedy Shriver National Institute of Child Health and Human Development). She is also a consultant for Mirvie. The other authors report no conflict of interest. |
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| Society for Maternal-Fetal Medicine/American Association of Obstetricians and Gynecologists Foundation Award (K.G.); NIH R01NR014784 (M.A.E.). The funding sources had no role in study design; collection, analysis, and interpretation of data; writing of the report; or in the decision to submit the article for publication. |
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| This work was accepted as an oral abstract (#9) in the 42nd annual meeting of the Society for Maternal-Fetal Medicine, Orlando, FL, January 31–February 5, 2022. |
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| Cite this article as: Gerson KD, Yang N, Anton L, et al. Second trimester short cervix is associated with decreased abundance of cervicovaginal lipid metabolites. Am J Obstet Gynecol 2022;227:273.e1-18. |
Vol 227 - N° 2
P. 273.e1-273.e18 - août 2022 Retour au numéro
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