Giulia Gaudiello

Background and Objectives: Maternal nutrition during pregnancy has been associated with fetal development and long-term health trajectories through mechanisms potentially involving epigenetic and metabolic programming. However, the molecular mediators linking dietary quality to fetal biochemical profiles remain poorly characterized. This exploratory pilot study aimed to investigate associations between maternal nutritional adequacy and the amniotic-fluid metabolomic profile during the second trimester. Materials and Methods: In this prospective study, AF samples from 41 pregnant women undergoing second-trimester amniocentesis were analyzed using gas chromatography–mass spectrometry (GC-MS). Nutritional status was assessed via the FIGO Nutrition Checklist. Subjects were divided into two groups based on dietary adequacy (FIGO Score >5 vs. ≤5). Multivariate analysis (PLS-DA, VIP scores, volcano plots) and pathway enrichment were performed to identify discriminatory metabolites. Results: Exploratory metabolomic analysis suggested differences between the two nutritional groups. Several candidate metabolites, including stearic acid, lactic acid, proline, and scyllo-inositol, contributed to the observed differences between groups. These features may provide preliminary hypotheses regarding energy-, amino acid-, and lipid-related biochemical pathways. Conclusions: Maternal dietary quality was associated with differences in the amniotic-fluid metabolomic profile. These preliminary findings support further investigation of amniotic-fluid metabolomics as a potential tool for studying the fetal biochemical environment.

Pregnancy is characterized by significant immunological changes and a cytokine profile, as well as vitamin deficiencies that can cause problems for the correct development of a fetus. Defensins are small antimicrobial peptides that are part of the innate immune system and are involved in several biological activities. Following that, this study aims to compare the levels of various cytokines and to investigate the role of defensins between pregnant women with confirmed COVID-19 infection and pregnant women without any defined risk factor. TNF-α, TGF-β, IL-2 and IL-10, β-defensins, have been evaluated by gene expression in our population. At the same time, by ELISA assay IL-6, IL-8, defensin alpha 1, defensin beta 1 and defensin beta 4 have been measured. The data obtained show that mothers affected by COVID-19 have an increase in pro-inflammatory factors (TNF-α, TGF-β, IL-2, IL-6, IL-8) compared to controls; this increase could generate a sort of “protection of the fetus” from virus attacks. Contemporarily, we have an increase in the anti-inflammatory cytokine IL-10 and an increase in AMPs, which highlights how the mother’s body is responding to the viral attack. These results allow us to hypothesize a mechanism of “trafficking” of antimicrobial peptides from the mother to the fetus that would help the fetus to protect itself from the infection in progress.