Perinatal epidemiology: Issues, challenges, and potential solutions

Prenatal exposures to endocrine disrupting chemicals: The role of multi-omics in understanding toxicity

Endocrine disrupting chemicals (EDCs) are a diverse group of toxicants detected in populations globally. Prenatal EDC exposures impact birth and childhood outcomes. EDCs work through persistent changes at the molecular, cellular, and organ level. Molecular and biochemical signals or 'omics' can be measured at various functional levels - including the epigenome, transcriptome, proteome, metabolome, and the microbiome. In this narrative review, we introduce each omics and give examples of associations with prenatal EDC exposures. There is substantial research on epigenomic modifications in offspring exposed to EDCs during gestation, and a growing number of studies evaluating the transcriptome, proteome, metabolome, or microbiome in response to these exposures. Multi-omics, integrating data across omics layers, may improve understanding of disrupted function pathways related to early life exposures. We highlight several data integration methods to consider in multi-omics studies. Information from multi-omics can improve understanding of the biological processes and mechanisms underlying prenatal EDC toxicity.

Prediction of pre-eclampsia

Pre-eclampsia is a leading cause of neonatal and maternal mortality and morbidity that complicates approximately 2-8% of all pregnancies worldwide. The precise cause of pre-eclampsia is not completely understood, with several environmental, genetic, and maternal factors involved in its pathogenesis and pathophysiology. An accurate predictor of pre-eclampsia will facilitate early recognition, close surveillance according to the individual risk and early intervention, and reduce the negative consequences of the disorder. Current evidence shows that no single test predicts pre-eclampsia with sufficient accuracy to be clinically useful. A combination of markers into multiparametric models may provide a more useful and feasible predictive tool for pre-eclampsia screening in the routine care setting than a test of either component alone. This review presents a summary of the current advances on prediction of pre-eclampsia, highlighting their performance and applicability. Key priorities when conducting research on predicting pre-eclampsia are also analyzed.