About this item:

45 Views | 87 Downloads

Author Notes:

Nicole S. Carlson, PhD, CNM Emory University Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road NE, Atlanta, GA 30322, nicole.carlson@emory.edu

The authors would like to thank Sudeshna Paul, PhD, for her assistance with statistical interpretation and format of tables and Rebecca M. Mitchell, PhD, for her assistance with R programming for data cleaning and analysis.

The authors declare that there is no conflict of interest.


Research Funding:

Drs. Nicole Carlson and Jennifer Frediani were supported by grant number K01NR016984 from the National Institute of Nursing Research during manuscript production.

This manuscript was supported by funding from the National Institutes of Health National Institutes of Nursing Research (R01NR014800), the Office of the Director [3R01NR014800, UG3OD023318], the National Institute of Environmental Health Sciences (P50ES926071), and the US Environmental Protection Agency (83615301 Mod. 2).


  • labor dystocia
  • mechanisms
  • metabolomics
  • obesity
  • parturition

Metabolomic Pathways Predicting Labor Dystocia by Maternal Body Mass Index


Journal Title:

AJP Reports


Volume 10, Number 1


, Pages E68-E77

Type of Work:

Article | Final Publisher PDF


Objectives The purpose of this study was to evaluate the metabolic pathways activated in the serum of African-American women during late pregnancy that predicted term labor dystocia. Study Design Matched case-control study (n = 97; 48 cases of term labor dystocia and 49 normal labor progression controls) with selection based on body mass index (BMI) at hospital admission and maternal age. Late pregnancy serum samples were analyzed using ultra-high-resolution metabolomics. Differentially expressed metabolic features and pathways between cases experiencing term labor dystocia and normal labor controls were evaluated in the total sample, among women who were obese at the time of labor (BMI ≥ 30 kg/m2), and among women who were not obese. Results Labor dystocia was predicted by different metabolic pathways in late pregnancy serum among obese (androgen/estrogen biosynthesis) versus nonobese African-American women (fatty acid activation, steroid hormone biosynthesis, bile acid biosynthesis, glycosphingolipid metabolism). After adjusting for maternal BMI and age in the total sample, labor dystocia was predicted by tryptophan metabolic pathways in addition to C21 steroid hormone, glycosphingolipid, and androgen/estrogen metabolism. Conclusion Metabolic pathways consistent with lipotoxicity, steroid hormone production, and tryptophan metabolism in late pregnancy serum were significantly associated with term labor dystocia in African-American women.

Copyright information:

© 2020 American Institute of Physics Inc.. All rights reserved.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Export to EndNote