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Objectives: Pregnant mothers use metabolites that cross the placenta to provide energy, structural components, essential nutrients, and signals to the developing fetus. However, fetal availability and absorption of many critical metabolites have not been investigated in healthy or diseased states; and associations between microbial metabolites and disease have not been thoroughly investigated. In our study, we addressed these shortcomings of fetal metabolic knowledge to better understand fetal metabolic exposure and its consequences.

Methods: We collected arterial and venous plasma from 536 umbilical cords at Lucile Packard Children’s Hospital. We then performed untargeted metabolomics and targeted lipidomics using a biphasic separation capturing the aqueous and organic phases. We obtained complete electronic health records for mother and newborn using the Stanford Research Repository, which …