Keele Research Repository

Pre-eclampsia (PE) and intrauterine growth restriction (IUGR) are common disorders associated with placental implantation abnormalities in early pregnancy. Both conditions are heterogeneous, having complex and multiple aetiologies. PE complicates 5-8 % of pregnancies globally, and is characterised by new onset hypertension and elevated urine protein concentration. PE is a major cause of maternal and fetal morbidity and mortality. IUGR may co-occur with PE or separately, and affects babies born at or below the bottom decile for weight. Monitoring for these conditions has a tremendous cost burden for healthcare providers, and as yet we have no robust clinical predictors to identify those women who need extra monitoring. Mass spectrometry and Fourier transform infrared spectroscopy were used to analyse proteins within urine samples from pregnant women. Proteomic and bioinformatics analyses of urine samples have demonstrated that proteins, subjected to ultrafiltration and subsequent proteolysis and peptide labelling, are readily detected in urine samples, with differential detection of proteins showing disparate levels in women whose pregnancies are complicated by IUGR and PE. Quantitative changes in urinary protein expression are investigated in order to identify proteins showing differential expression in early pregnancy (15 weeks gestation) in the urine of patients who go on to develop pregnancy complications. A number of candidate proteins showing altered expression levels have been identified for future follow-up analysis. This project suggests new methods of clinical diagnostics for these conditions, which could aid improved targeting of intensive monitoring in prenatal care.