Identification of indicators for preterm birth using retinoid metabolites

Young Ah You, Soo Yeon Hwang, Soo Min Kim, Seojeong Park, Ga In Lee, Sunwha Park, Abuzar Ansari, Jeongae Lee, Youngjoo Kwon, Young Ju Kim

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7 Scopus citations


Metabolites reflect the biochemical dynamics for the maintenance of pregnancy and parturition. UPLC-Q/TOF-MS and LC-MS/MS metabolomics were performed to identify and validate the plasma metabolomic signatures of preterm birth (PTB). We recruited pregnant women between 16 and 40 weeks 5 days gestational age at Ewha Womans Mokdong Hospital for a nested case-control study. In untargeted UPLC-Q/TOF-MS, score plots of partial least-squares discriminant analysis clearly separated the PTB group from the term birth (TB, n = 10; PTB, n = 11). Fifteen metabolites were significantly different between the two groups, as indicated by a variable importance in projection >1 and p < 0.05. Metabolic pathways involving retinol, linoleic acid, D-arginine, and D-ornithine were associated with PTB. Verification by LC-MS/MS focused on retinol metabolism (TB, n = 39; PTB, n = 20). Retinol levels were significantly reduced in PTB compared to TB, while retinal palmitate, all-trans-retinal, and 13-cis-retinoic acid (13 cis-RA) significantly increased (p < 0.05). Retinol-binding protein levels were also elevated in PTB. Additionally, all-trans-retinal (AUC 0.808, 95% CI: 0.683–0.933) and13 cis-RA (AUC 0.826, 95% CI: 0.723–0.930) showed improved predictions for PTB-related retinol metabolites. This study suggests that retinoid metabolism improves the accuracy of PTB predictions and plays an important role in maintaining pregnancy and inducing early parturition.

Original languageEnglish
Article number443
Issue number7
StatePublished - Jul 2021

Bibliographical note

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© 2021 by the authors. Licensee MDPI, Basel, Switzerland.


  • 13-cis-retinoic acid
  • Metabolomic analysis
  • Parturition
  • Preterm birth
  • Retinoid metabolism


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