Abstract

Urinary metabolomics is of increasing importance as a means of identifying metabolic signatures associated with health and disease states. Thirty-one late preterm infants (LPs) admitted to the neonatal intensive care unit (NICU) and 23 age-matched healthy LPs admitted to the maternity ward of a tertiary hospital were enrolled in the study. Urinary metabolism was analyzed using proton nuclear magnetic resonance spectroscopy (1H-NMR) on the first postnatal day of the neonate and on her third day. Data were analyzed using univariate and multivariate statistical analyses. A unique metabolic pattern of increased metabolites was found in her LP admitted to her NICU from the first day of life. LPs with pulmonary insufficiency had different metabolic profiles. This discrepancy may reflect variations in nutrient intake or differences in gut microbiota due to medical interventions such as administration of antibiotics and other drugs. Altered metabolites may serve as biomarkers to identify LP neonates with severe disease or at increased risk of adverse outcomes later in life, including metabolic risk. Novel biomarker discovery reveals potential drug development targets and optimal time periods for effective intervention, providing a personalized approach.