Early potential metabolic biomarkers of primary postpartum haemorrhage based on serum metabolomics

Objectives: Postpartum hemorrhage (PPH) is the leading cause of maternal death, accounting for 1/4 of maternal deaths worldwide. Determining sensitive biomarkers in the peripheral blood to identify postpartum haemorrhage (PPH) is essential for the early diagnosis and management of PPH. The purpose of this study is to identify predictive serum metabolic biomarkers of PPH. Thirty healthy pregnant women and 30 cases of postpartum hemorrhage were studied for our research. Material and methods: The serum metabolites of all pregnant were detected by liquid chromatography-quadruple time-of-flight mass spectrometry (LC-QTOFMS) and the corresponding biomarkers were identified. Results: 34 significantly altered metabolites in PPH-pre-group were identified. They were mainly involved in fatty acid, and glycerophospholipid metabolism. Conclusions: The LysoPCs, PCs, PGs, PIs were effective biomarkers for identifying PPH. The disturbed signaling pathways, mTOR signaling, acute phase response signaling, AMPK signaling and eNOS signaling pathways might be related to the etiopathogenesis of PPH. Our study provided a valuable attempt to screen early diagnostic markers of PPH and to further understand its pathogenesis