Amer J Perinatol 2017; 34(11): 1078-1083
DOI: 10.1055/s-0037-1603817
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Women with Symptomatic Preterm Birth Have a Distinct Cervicovaginal Metabolome

Jeny Ghartey1, Laura Anglim1, Julie Romero1, Amy Brown1, Michal A. Elovitz1
  • 1Department of Obstetrics and Gynecology, Maternal-Child Health Research Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
Further Information

Publication History

10 May 2017

11 May 2017

Publication Date:
12 June 2017 (eFirst)


Objective The objective was to determine if women with symptoms of preterm labor who ultimately have a spontaneous preterm birth (sPTB) have a distinct cervicovaginal (CV) metabolome compared with women who deliver at term.

Study Design A nested case–control study of women presenting with symptoms of preterm labor was performed. CV fluid was collected from women between 22 and 336/7 weeks' gestation. The CV metabolome was compared between women with sPTB (n = 20) and women who delivered at term (n = 30). Global biochemical profiles were determined using ultraperformance liquid chromatography/tandem mass spectrometry. Welch's two-sample t-test was used to identify metabolites that differed significantly. Level of significance was defined as p ≤ 0.05.

Results Eighty-eight percent of women were African-American and none had a prior history of sPTB. A total of 301 metabolites were identified in CV fluid. Thirty metabolites were significantly different in women with preterm birth compared with term birth. Two metabolites (mannitol and methyl phosphate) were significantly upregulated, and the remaining 28 metabolites were significantly downregulated and consisted of medium chain-fatty acids and collagen degradation markers.

Conclusion The CV metabolome is significantly altered among women who present with preterm labor symptoms and ultimately have a sPTB.


This research was presented as a poster presentation at the 37th Annual Meeting for the Society for Maternal-Fetal Medicine in Las Vegas, NV, January 23 to 28, 2017.


The funding was provided by Maternal and Child Health Research Fund.