Metabolic derangements in IUGR neonates detected at birth using UPLC-MS
Background: Intrauterine growth restriction (IUGR) is associated with short- and long-term metabolic consequences which are possibly dictated by in utero programming together with environmental and dietetic manipulation after birth. Early detection of metabolic derangements in these babies through metabolomics approach will help recognition of cases in need for further follow-up and can help future development of therapeutic and preventive strategies for the late consequences.
Objective: To compare amino acids and acyl carnitine levels in neonates with IUGR to normal birth weight controls; as a part of metabolic profiling.
Methods: Cord blood samples were collected at birth from 40 small-for-gestational-age (SGA) neonates and 20 normal birth weight gestational age-matched neonates, for quantification of amino acids and acylcarnitines using Ultra Performance Liquid Chromatography-Mass Spectrometry (UPLC-MS).
Results: Significantly elevated acylcarnitine levels especially C18-OH and C16-OH were found in IUGR neonates vs. controls (p < 0.001). Specific amino acids that were significantly elevated in IUGR neonates included Histidine, Methionine, Arginine, Aspartic, Valine, Alanine, Leucine, Isoleucine, Glutamic acid, Tyrosine, Ornithine, Phenylalanine, and lastly citrulline. These derangements were recognized to be similar to those found in different disorders.
Conclusion: We conclude that IUGR neonates have unique metabolic derangements detectable by UPLCMS at birth with similarities to derangements found in certain disorders. These babies should be closely followed up for early detection of the metabolic consequences of IUGR.