Urinary profiles associated with bacterial metabolites from asymptomatic pregnant women with at term or preterm premature rupture of membranes: a pilot study

Detection of Vaginal Metabolite Changes in Premature Rupture of Membrane Patients in Third Trimester Pregnancy: a Prospective Cohort Study

Premature rupture of membranes (PROM) is usually associated with pregnant and neonatal complications. Most of the PROM cases are caused by ascending asymptomatic genital infection. In China, PROM (15.3%) is more common than spontaneous preterm labor (7.3%) and leads to more adverse pregnancy outcomes. Here, we designed a prospective cohort study to measure the metabolomics changes in vaginal swab samples and explored their potential contribution to PROM. A total of 260 differentially expressed metabolites were identified and further analyzed. In the PROM group, N-acetyl-D-galactosamine and sucrose were downregulated (P = 0.0025, P = 0.0195, respectively), both of which are the upstream metabolites of the glycolysis pathway. Furthermore, estriol 3-sulfate 16-glucuronide (P = 0.0154) and 2-methoxy-17beta-estradiol 3-glucosiduronic acid (P = 0.004), two final metabolites in steroid hormone biosynthesis, were both downregulated in the PROM group. Finally, we found two catechin metabolites (epigallocatechin-7-glucuronide, P = 0.0009; 4'-methyl-epigallocatechin-7-glucuronide, P = 0.01) as well as DL-citrulline (P = 0.0393) were also significantly downregulated in the PROM group compared with the healthy control (HC) group, which are related to important antioxidant and anti-inflammatory activities in the human body. Altogether, metabolite changes in glycolysis, steroid hormone biosynthesis, and antioxidant/anti-inflammatory pathways may contribute to (or be a consequence of) vaginal dysbiosis and PROM. Metabolite pathway analysis is a new and promising approach to further investigate the mechanism of PROM and help prevent its unfavorable pregnant outcomes at a functional level. Trial registration number: ChiCTR2000034721.

A routine urine test has partial predictive value in premature rupture of the membranes

OBJECTIVE

This study aimed to examine the predictive value of a routine urine test for premature rupture of the fetal membranes.

METHODS

Routine urine test data of 100 patients with preterm premature rupture of the membranes (PPROM) and 100 patients with full-term premature rupture of the membranes (PROM) were collected by the case-based method. Additionally, 100 healthy pregnant women and 100 nonpregnant adult healthy women were selected as the negative control group and blank control group, respectively. A receiver operating characteristic curve was established after identifying the different parameters.

RESULTS

We found that occult blood, glucose, ketone bodies, urine specific gravity, red blood cell count, epithelial cell count, bacteria, yeast, crystals, and electrical conductivity were significantly different between the PPROM and PROM groups. There were significant differences in occult blood, protein, glucose, ketone bodies, pH, red blood cell count, bacteria, urine specific gravity, crystals, and electrical conductivity between the PPROM and full-term groups. Receiver operating characteristic curve analysis showed that when the cut-off for bacteria was 130.15, it had the largest area under the curve value of 0.696.

CONCLUSION

A routine urine test, especially for bacterial counts, has certain predictive value for PROM.