Preliminary Metabolomics Data Reveals Lipid Metabolism and Oxidative Stress Metabolites as Potential Biomarkers for Patent Ductus Arteriosus

Patent ductus arteriosus (PDA) is a common congenital heart defect in preterm infants and is associated with significant morbidity. Early diagnosis is crucial but challenging due to nonspecific clinical symptoms. This study aims to identify potential metabolomic biomarkers for early detection of PDA using human cord blood. A prospective cross-sectional study was conducted involving 45 preterm infants between 23^0/6 and 31^6/7 weeks of gestation. The diagnosis of hemodynamically significant PDA (hsPDA) was based on echocardiographic findings after 48 h, showing a left atrium-to-aortic root ratio > 1.5 and/or a ductus diameter > 1.5 mm. Untargeted metabolomics analysis was performed on cord blood plasma samples using quadrupole time-of-flight liquid chromatography-mass spectrometry (Q-TOF LC/MS). Data were processed for metabolites that differed between groups. Twenty infants with hsPDA formed the study group, 25 controls. Out of 4237 detected peaks, 40 showed statistically significant differences (fold change > 1.5,p < 0.05). Among these, 15 metabolites were potentially clinically relevant. Key findings included decreased levels of guanidino acetic acid, S-adenosylmethionine, and ceramides and increased levels of docosahexaenoic acid, arachidonic acid, and cholesterol-related molecules in the PDA group. The study reveals significant metabolic alterations in lipid metabolism and oxidative stress-related pathways in PDA infants. Further targeted metabolomics studies are warranted to validate and explore clinical applications.