[Metabolic profiles in umbilical cord blood associated with neonatal brain injury in selective fetal growth restriction].

This study aimed to analyze metabolic characteristics of the umbilical cord blood associated with brain injury in neonates with selective fetal growth restriction (sFGR). A prospective cohort of 30 sFGR twin pairs delivered at Peking University Third Hospital between September 2017 and December 2019 was enrolled. Maternal-fetal clinical data and information on neonatal complications, including brain injury, were collected for both the growth-restricted (sFGR-S) and larger (sFGR-L) fetuses. The mean maternal age at delivery was (30.7±3.9) years, and the mean gestational age at delivery was (32.7±2.2) weeks. Among the 30 sFGR cases, there were 12 cases of type Ⅰ, 11 type Ⅱ, and 7 type Ⅲ. The cohort comprised 30 male and 30 female neonates (50% each). Brain injury occurred in 12 (40%) of the sFGR-S group, including 7 cases of intracranial hemorrhage (IVH), 3 cases of periventricular leukomalacia (PVL), and 2 case with both. In the sFGR-L group, brain injury occurred in 9 (30%) neonates, including 6 cases of IVH, 2 cases of PVL, and 1 case with both. Receiver operating characteristic (ROC) curve analysis for the sFGR-S group yielded an area under the curve (AUC) of 0.853 (95%CI: 0.698-1.000) for tyrosine alone, and an AUC of 0.944 (95%CI: 0.859-1.000) for the combination of tyrosine and myristic acid. For the sFGR-L group, the AUC was 0.880 (95%CI: 0.708-1.000) for S-adenosyl methionine (SAM) alone, and 0.917 (95%CI: 0.749-1.000) for the combination of SAM and trans-vaccenic acid. In conclusion, neonates in the sFGR-S and sFGR-L groups exhibit distinct metabolic profiles, and differential metabolites with their related pathways hold potential predictive value for neonatal brain injury.