Amino Acid Profiles in Dried Blood Spots and Clinical Outcomes in Selective Fetal Growth Restriction: A Twin-Pair Study
- 1National Medical Research Center for Obstetrics Gynecology and Perinatology Named After Academician V.I. Kulakov of the Ministry of Healthcare of Russian Federation, 117997 Moscow, Russia
- 2Department of Obstetrics, Gynecology, Perinatology and Reproductology, Institute of Professional Education, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, 119991 Moscow, Russia
Abstract
Selective fetal growth restriction (sFGR) remains a leading cause of perinatal morbidity in multiple pregnancies; however, its pathogenesis is not yet fully elucidated. Investigating amino acid metabolism in weight-discordant twins may uncover critical metabolic pathways involved in this condition, given the essential roles of amino acids in fetal growth and energy supply. The use of dried blood spots (DBSs) enables the minimally invasive, retrospective evaluation of neonatal metabolic profiles, providing a unique opportunity to identify sFGR-associated signature and clarify differences between monochorionic (MC) and dichorionic (DC) placentation. In the present study, we profiled 23 amino acids in DBS from 23 twin pairs (11 discordant and 12 non-discordant, defined by postnatal birth-weight discordance), stratified by chorionicity, to identify specific metabolic signatures associated with sFGR and to evaluate their temporal dynamics and clinical significance. Our findings suggest that chorionicity is associated with distinct amino acid signatures of postnatal birth-weight discordance. In MC twins, the larger co-twin displayed significantly elevated glycine, α- and γ-aminobutyric acids, serine, asparagine, and citrulline, alongside reduced proline and tryptophan. In DC twins, the larger co-twin exhibited higher α-aminobutyric acid, valine, leucine, arginine, and citrulline, whereas glycine was elevated in the smaller co-twin. Pathway enrichment analysis further suggested the enrichment of amino acid transport and protein synthesis pathways in MC postnatal discordance and nitric oxide (NO)-dependent signaling in DC postnatal discordance. Longitudinal follow-up showed a statistically significant attenuation of intrapair differences for several amino acids by the second time point. All 11 discordant pairs were retrospectively confirmed to fulfil the Delphi criteria for sFGR. These findings are exploratory and hypothesis-generating.
Related
- Incremental Prognostic Value of Fetal Doppler Beyond Biometry for Adverse Perinatal Outcomes in Suspected Fetal Growth Restriction: A Retrospective Cohort Study
- Comparative Metabolomic Profiling of Amino Acids in Dried Blood Spots from Dichorionic and Monochorionic Twins Complicated by Selective Fetal Growth Restriction and Twin-to-Twin Transfusion Syndrome
- Why only one-quarter of placental fetal growth restriction triggers preeclampsia? Clinical risk factors in 2060 cases in a 24-year cohort of 90,000 births
- Risk Factor Profiles and Clinical Outcomes: A 6-Month Longitudinal Study on Rehospitalization Rates in Patients with Chronic Heart Failure
- Sex-specific clinical profiles and long-term outcomes in adolescents and young people at clinical high risk for psychosis: Findings from the PARMS program
BibTeX
@article{chagovets2026amino,
title = {{Amino Acid Profiles in Dried Blood Spots and Clinical Outcomes in Selective Fetal Growth Restriction: A Twin-Pair Study}},
author = {Vitaliy V. Chagovets and Alisa O. Tokareva and Natalia A. Frankevich and Anastasia V. Novoselova and Marina N. Yushina and Fadi Hajjar and Chupalav M. Eldarov and Olga V. Michailova and Tamara E. Karapetyan and Irina I. Ryumina and Vladimir E. Frankevich and Gennady T. Sukhikh},
journal = {International Journal of Molecular Sciences},
year = {2026},
month = oct,
doi = {10.3390/ijms27209156},
url = {https://www.mdpi.com/1422-0067/27/20/9156},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Amino Acid Profiles in Dried Blood Spots and Clinical Outcomes in Selective Fetal Growth Restriction: A Twin-Pair Study
AU - Vitaliy V. Chagovets
AU - Alisa O. Tokareva
AU - Natalia A. Frankevich
AU - Anastasia V. Novoselova
AU - Marina N. Yushina
AU - Fadi Hajjar
AU - Chupalav M. Eldarov
AU - Olga V. Michailova
AU - Tamara E. Karapetyan
AU - Irina I. Ryumina
AU - Vladimir E. Frankevich
AU - Gennady T. Sukhikh
PY - 2026
DA - 2026/10/01
JO - International Journal of Molecular Sciences
DO - 10.3390/ijms27209156
UR - https://www.mdpi.com/1422-0067/27/20/9156
AB - Selective fetal growth restriction (sFGR) remains a leading cause of perinatal morbidity in multiple pregnancies; however, its pathogenesis is not yet fully elucidated. Investigating amino acid metabolism in weight-discordant twins may uncover critical metabolic pathways involved in this condition, given the essential roles of amino acids in fetal growth and energy supply. The use of dried blood spots (DBSs) enables the minimally invasive, retrospective evaluation of neonatal metabolic profiles, providing a unique opportunity to identify sFGR-associated signature and clarify differences between monochorionic (MC) and dichorionic (DC) placentation. In the present study, we profiled 23 amino acids in DBS from 23 twin pairs (11 discordant and 12 non-discordant, defined by postnatal birth-weight discordance), stratified by chorionicity, to identify specific metabolic signatures associated with sFGR and to evaluate their temporal dynamics and clinical significance. Our findings suggest that chorionicity is associated with distinct amino acid signatures of postnatal birth-weight discordance. In MC twins, the larger co-twin displayed significantly elevated glycine, α- and γ-aminobutyric acids, serine, asparagine, and citrulline, alongside reduced proline and tryptophan. In DC twins, the larger co-twin exhibited higher α-aminobutyric acid, valine, leucine, arginine, and citrulline, whereas glycine was elevated in the smaller co-twin. Pathway enrichment analysis further suggested the enrichment of amino acid transport and protein synthesis pathways in MC postnatal discordance and nitric oxide (NO)-dependent signaling in DC postnatal discordance. Longitudinal follow-up showed a statistically significant attenuation of intrapair differences for several amino acids by the second time point. All 11 discordant pairs were retrospectively confirmed to fulfil the Delphi criteria for sFGR. These findings are exploratory and hypothesis-generating.
SN - 1422-0067
ER -