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\begin{document}

\title{Detection of preterm birth by maternal urinary volatile organic compound
analysis: a prospective cohort study}



\author[1]{Emma Ronde}%
\author[2]{Nina Frerichs}%
\author[1]{Shauni Brantenaar}%
\author[2]{Sofia El Manouni El Hassani}%
\author[3]{Alfian Wicaksono}%
\author[3]{James Covington}%
\author[2]{Nanne De Boer}%
\author[2]{Tim De Meij}%
\author[4]{Thomas Hankemeier}%
\author[1]{Irwin Reiss}%
\author[1]{Sam Schoenmakers}%
\affil[1]{Erasmus Medical Center}%
\affil[2]{Amsterdam University Medical Centres}%
\affil[3]{University of Warwick}%
\affil[4]{Leiden University Leiden Academic Centre for Drug Research}%


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  \date{May 16, 2024}


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\begin{abstract}
Objective: Prediction of preterm birth is currently not feasible,
resulting in maternal and fetal overexposure to prenatal corticosteroids
and unnecessary hospital admittance. Novel biomarkers seem to hold
potential for predictive applicability, including non-invasive volatile
organic compounds. In this study, we aimed to assess the potential of
urinary volatile organic compound profiles (VOCs) in the identification
of pregnant women at risk for preterm birth. Design, setting,
population: We prospectively collected urine of women admitted for
imminent preterm birth ([?] 24+0 weeks until 36+6 weeks), collected data
on maternal characteristics, including urine cultures, time between
admission and delivery and mode of delivery. Methods and main outcome
measures: Urine samples were analyzed using gas chromatography coupled
to an ion mobility spectrometer (GC-IMS). VOCs of women delivering
preterm and term were compared. Results: Urinary VOCs differed between
women delivering between 28+0 until 36+6 weeks compared to women
admitted for imminent preterm birth but delivering at term (area under
the curve: 0.70). We identified women with either chorioamnionitis (area
under the curve: 0.72) and positive bacterial cultures (area under the
curve: 0.97) based on their urinary VOCs. Conclusions: Urinary VOCs hold
potential for non-invasive prediction of preterm birth. Furthermore,
they may allow for detection of chorioamnionitis and urinary tract
infections in the investigated population. These observations need to be
validated in a larger population prior to clinical implementation.
Funding: This study was funded by the Department of Obstetrics and
Prenatal diagnosis. Keywords: preterm birth, premature delivery,
volatile organic compounds, chorioamnionitis, urinary tract infection,
infection%
\end{abstract}%



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