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Poster Session 2

Category: Clinical Obstetrics

Poster Session 2

(406) Metabolomic Profiles in Patients with Postpartum Hemorrhage

Wednesday, February 11, 2026

3:30 PM - 5:00 PM

Submitting Author and Presenting Author(s)

Alesha M. White, MD (she/her/hers)

Maternal Fetal Medicine Fellow
University of Texas Southwestern Medical Center
Grand Prairie, Texas, United States

Coauthor(s)

AW

Andrea Woods, MS

University of Texas Southwestern Medical Center
Dallas, Texas, United States
AS

Ashley Solmonson, PhD

University of Texas Southwestern Medical Center
Dallas, Texas, United States
David B. Nelson, MD (he/him/his)

Associate Professor and Division Chief
University of Texas Southwestern Medical Center
Dallas, Texas, United States

Objective:
Serum metabolic profiles from patients who experience postpartum hemorrhage (PPH) are potential therapeutic targets but are largely unknown. The purpose of this study is to describe metabolomic profiles as they relate to PPH.

Study Design:
This is a prospective observational study of patients who experienced PPH or who were at risk of experiencing PPH at the time of delivery. This data is a subgroup from a single-center within a larger, multicenter industry sponsored study to validate a point of care viscoelastic assay device, the Quantra® sonorheometry (SEER) system. Metabolites were extracted from maternal serum using 80% acetonitrile. Metabolomic analysis was performed using a Vanquish UHPLC coupled to a Thermo Scientific Exploris 240 hybrid quadrupole orbitrap high-resolution mass spectrometer. Relative metabolite abundance was compared between patients experiencing PPH and controls. Metabolites that were increased or decreased by 20% were compared between patients with PPH and those without. Metabolite data were tested for significance using unpaired parametric t-test or Mann-Whitney test.

Results:
Metabolomics data was collected from 41 samples and 33 (80%) experienced PPH. A supervised PLS-DA analysis demonstrated that the metabolic profile for patients with PPH was distinct from patients without PPH (Figure 1). A total of 166 metabolites were identified and 29 were significantly different between PPH and controls. From the total list, 39 metabolites were increased by 20% (14 significant) and 56 were decreased by 20% (15 significant). Among all cases of PPH, the metabolites that were significantly and consistently decreased were amnio acids. This was driven by three non-essential amino acids, theronine, L-lysine and leucine (Figure 2).

Conclusion:
Serum metabolomic profiles differ in patients with and without PPH. Patients who experience PPH specifically lack the metabolites related to amnio acid metabolism, specific to non-essential amnio acids available via diet. This suggests a nutritional role in risk of PPH. Future large prospective studies are needed to confirm these findings.