The influence of hypertensive disorders in pregnancy on neonatal amino acid and acylcarnitine levels

Shiyi Xu¹Fei Kong²Shuting Huang³Qiuping Liao⁴Jinying Luo⁴Jinfu Zhou^5*

• ¹College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, China
• ²Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, Fujian Province, China
• ³Department of Preventive Medicine School of Public Health, Fujian Medical University, Fuzhou, Fujian Province, China
• ⁴Department of Obstetrics and Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, China
• ⁵Medical Genetic Diagnosis and Therapy Center, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China

Background/Objectives: Hypertensive disorders in pregnancy (HDP) are associated with an increased risk of neonatal complications; however, their effects on neonatal metabolism remain inadequately understood. The aim of this study was to assess the association between HDP and neonatal amino acid and acylcarnitine levels. Methods: In this retrospective case-control study, 1,228 singleton pregnant women diagnosed with HDP and 1,228 normal singleton pregnant women whose newborns underwent newborn screening for 11 amino acids and 31 acylcarnitines were recruited from January 2021 to December 2023. Results: After adjusting for potential confounding factors, including gestational age at delivery, birth weight and neonatal sex, nine amino acids exhibited significant differences between infants born to mothers in the HDP subgroups compared to those born to mothers with normal pregnancies. These amino acids were involved in arginine and proline metabolism and the urea cycle pathway. Amino acid levels also varied among the HDP subgroups. Additionally, the levels of short-, medium-, and long-chain acylcarnitines were significantly higher in newborns born to mothers in the HDP subgroups than in newborns born to mothers in the normal pregnancy group. However, no statistically significant differences were observed among the four HDP subgroups. Conclusions: Our findings revealed a significant link between HDP and neonatal amino acid and acylcarnitine levels, which were involved in arginine and proline metabolism, the urea cycle, and fatty acid oxidation. These results underscore the significance of identifying maternal conditions that affect newborn metabolites to ensure adequate nutrition and enhance neonatal health outcomes.