METHOD FOR PREDICTING ANTENATAL FETAL DEATH

Background. The problem of antenatal fetal death is one of the key tasks of modern medicine that requires a comprehensive approach, including the development of new diagnostic methods, improvement of obstetric care and provision of social and psychological support for families facing perinatal loss. Further research is needed to find a combination of new prognostic biomarkers using modern omics technologies. Objective. Developing a method for predicting antenatal fetal death based on the study of the metabolomic profile of free amino acids in women in the 3rd trimester of pregnancy. Material and methods. At the first stage, blood plasma was collected from 722 women with one or more maternal risk factors for the development of fetoplacental insufficiency at 28-38 weeks of pregnancy. The outcomes of pregnancy and childbirth in these patients were analyzed. At the 2nd stage 34 patients were included: the 1st group (main) of 12 patients who had antenatal death of the fetus in the 3rd trimester of pregnancy; the 2nd group (control) – 22 women with physiological course of pregnancy and birth of a newborn, without signs of chronic hypoxia. Analysis of 48 amino acids and their derivatives was carried out using high-performance liquid chromatography. Results. Statistically significant differences in the concentration of 7 amino acids and their derivatives in the control groups were revealed: cysteine acid (CA), aspartate (Asp), glutathione (GSH), glutamate (Glu), 3-methylhistidine (3MHis), carnosine (Car), taurine (Tau), p<0.05. The method of logistic regression was used to obtain a formula that includes the evaluation of the concentration of taurine and methionine in the blood plasma of women in the 3rd trimester of pregnancy; when calculating the index p>0.569 a high probability of antenatal fetal death is predicted. Conclusions. A method for predicting antenatal fetal death in the 3rd trimester of pregnancy with a sensitivity of 95.5% and a specificity of 91.7% is proposed.