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mSep: investigating physiological and immune-metabolic biomarkers in septic and healthy pregnant women to predict feto-maternal immune health – a prospective observational cohort study protocol

Sharma, Simran, Zaher, Summia, Rodrigues, Patrícia R. S., Davies, Luke C, Edkins, Sarah, Strang, Angela, Chakraborty, Mallinath, Watkins, W. John ORCID: https://orcid.org/0000-0001-8759-6588, Andrews, Robert, Parkinson, Edward, Angelopoulos, Nicos, Moet, Linda, Shepherd, Freya, Davies, Kate Megan, White, Daniel, Oram, Shaun, Siddall, Kate, Keeping, Vikki, Simpson, Kathryn, Faggian, Federica, Bray, Maryanne, Bertorelli, Claire, Bell, Sarah, Collis, Rachel E., McLaren, James E., Labeta, Mario, O’Donnell, Valerie B. and Ghazal, Peter ORCID: https://orcid.org/0000-0003-0035-2228 2022. mSep: investigating physiological and immune-metabolic biomarkers in septic and healthy pregnant women to predict feto-maternal immune health – a prospective observational cohort study protocol. BMJ Open 12 (9) , e066382. 10.1136/bmjopen-2022-066382

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License URL: http://creativecommons.org/licenses/by-nc/4.0/
License Start date: 16 September 2022

Abstract

Introduction: Maternal sepsis remains a leading cause of death in pregnancy. Physiological adaptations to pregnancy obscure early signs of sepsis and can result in delays in recognition and treatment. Identifying biomarkers that can reliably diagnose sepsis will reduce morbidity and mortality and antibiotic overuse. We have previously identified an immune-metabolic biomarker network comprising three pathways with a >99% accuracy for detecting bacterial neonatal sepsis. In this prospective study, we will describe physiological parameters and novel biomarkers in two cohorts—healthy pregnant women and pregnant women with suspected sepsis—with the aim of mapping pathophysiological drivers and evaluating predictive biomarkers for diagnosing maternal sepsis. Methods and analysis: Women aged over 18 with an ultrasound-confirmed pregnancy will be recruited to a pilot and two main study cohorts. The pilot will involve blood sample collection from 30 pregnant women undergoing an elective caesarean section. Cohort A will follow 100 healthy pregnant women throughout their pregnancy journey, with collection of blood samples from participants at routine time points in their pregnancy: week 12 ‘booking’, week 28 and during labour. Cohort B will follow 100 pregnant women who present with suspected sepsis in pregnancy or labour and will have at least two blood samples taken during their care pathway. Study blood samples will be collected during routine clinical blood sampling. Detailed medical history and physiological parameters at the time of blood sampling will be recorded, along with the results of routine biochemical tests, including C reactive protein, lactate and white blood cell count. In addition, study blood samples will be processed and analysed for transcriptomic, lipidomic and metabolomic analyses and both qualitative and functional immunophenotyping. Ethics and dissemination: Ethical approval has been obtained from the Wales Research Ethics Committee 2 (SPON1752-19, 30 October 2019). Trial registration number: NCT05023954.

Item Type: Article
Date Type: Published Online
Status: Published
Schools: Medicine
Additional Information: License information from Publisher: LICENSE 1: URL: http://creativecommons.org/licenses/by-nc/4.0/, Start Date: 2022-09-16, Type: open-access
Publisher: BMJ Publishing Group
ISSN: 2044-6055
Date of First Compliant Deposit: 23 September 2022
Date of Acceptance: 24 August 2022
Last Modified: 30 Nov 2022 08:50
URI: https://orca.cardiff.ac.uk/id/eprint/152809

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