Hair Lipidomics for Prediction and Pathogenesis of Late-Onset Fetal Growth Restriction

Document Type

Conference Proceeding

Publication Date

1-2026

Publication Title

Pregnancy

Abstract

Objective: Late-onset fetal growth restriction (LO-FGR), or FGR diagnosed ≥ 32 weeks, is associated with increased risk of perinatal asphyxia and death. A meta-analysis showed that 36-week biometry has limited accuracy for predicting LO-FGR (Mustafa 2024). Lipids are critical for fetal growth and placental function. We therefore evaluated maternal hair lipidomics for the prediction of and to elucidate the pathogenesis of LO-FGR. Study Design: This prospective case-control study included 29 LO-FGR cases and 27 appropriately grown controls. Hair samples were profiled using Ultra-High-Performance Liquid Chromatography coupled with Mass Spectrometry. Mean lipid concentrations, LO-FGR vs controls, were compared. Logistic regression models were developed for the detection of LO-FGR. Areas under the curve (AUC), sensitivity, and specificity values for LO-FGR prediction based on lipids-only and lipids combined with 3rd trimester abdominal circumference (AC) measurement. Metabolite set enrichment analysis (MSEA) was conducted to identify the dysregulated biochemical pathways. Results: There was no difference in mean gestational age at sample collection: 35.6 ± 1.9 vs 35.5 ± 2.5 weeks (p = 0.482) for cases vs controls. In total, 398 lipids were detected in maternal hair. Overall, statistically significant alterations (p < 0.05) in concentrations of 44 lipids were found. The majority of these were triglycerides and diacylglycerols. A lipidomics-only model achieved excellent diagnostic accuracy: AUC (95% CI) = 0.92 (0.84–0.999) on cross-validation testing (Figure 1). Lipids plus 3rd trimester AC had a higher predictive accuracy of AUC (95% CI) = 0.932 (0.861–1.00) (Figure 2). MSEA identified dysregulation of important lipid metabolic pathways (p < 3x10−6), including mitochondrial beta-oxidation of short-chain fatty acids and oxidation of branched chain fatty acids in LO-FGR. Conclusion: Lipid biomarkers in hair achieved high diagnostic accuracy and could represent a novel non-invasive tool for LO-FGR detection. Profound lipid disturbance including mitochondrial dysfunction was significantly associated with LO-FGR development.

Volume

2

Issue

S1

First Page

185

Comments

Society for Maternal-Fetal Medicine (SMFM) 2026 Pregnancy Meeting, February 8-13, 2026, Las Vegas, NV

Last Page

186

DOI

10.1002/pmf2.70168

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