Maternal Blood Biomarkers Identify Risk of Preterm and Early-Term Birth

Preterm and early-term births can lead to lasting complications because vital organs continue to mature during the final weeks of pregnancy. Babies born too soon face increased risks of breathing difficulties, hearing loss, and vision problems, yet clinicians still lack reliable early indicators to distinguish spontaneous from medically indicated early delivery. A new study identifies distinct metabolomic signatures in maternal blood associated with both the timing and type of early birth.

At Emory University’s Rollins School of Public Health (Atlanta, GA, USA), investigators analyzed blood samples from pregnant African American women in Atlanta to compare metabolomic profiles between pregnancies that ended early and those that reached full term. The study aimed to identify molecular differences, or metabolomic signatures, detectable as early as the first trimester. The team also assessed whether these profiles varied between spontaneous early births and deliveries prompted by medical concerns affecting the mother or baby.

The analysis identified molecular signals in maternal blood that may help explain whether a pregnancy is more likely to end preterm, early term, or reach full term. Patterns associated with spontaneous early births frequently involved amino acids, which support fetal growth, placental function, and stress responses. In contrast, early deliveries prompted by medical indications were characterized by signatures linked to lipid energy metabolism and markers of cardiac and metabolic stress.

Findings from the study, “Maternal metabolomic signatures for risk of preterm and early term birth in African American women,” were published in Nature Health on June 16, 2026. According to the authors, the results provide biological clues that may enhance understanding of early birth mechanisms and, in the future, could inform the development of improved tools to identify higher-risk pregnancies. The work underscores that preterm and early-term births do not reflect a single pathway and may require distinct analytic considerations.

“Preterm and early-term births are not one single condition with one single cause. Our study shows that different types of early birth carry distinct molecular fingerprints during pregnancy. These findings may help us better understand the biology of early birth and, eventually, develop better tools to identify risk earlier and guide prevention strategies,” said Donghai Liang, PhD, associate professor of environmental health at Rollins and the study’s lead author.

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Emory University’s Rollins School of Public Health