Research Article PROM and Labour Effects on Urinary Metabolome: A Pilot Study Alessandra Meloni, 1 Francesco Palmas, 2 Luigi Barberini , 3 Rossella Mereu, 1 Sara Francesca Deiana, 1 Maria Francesca Fais, 1 Antonio Noto , 4 Claudia Fattuoni , 2 Michele Mussap, 5 Antonio Ragusa, 6 Angelica Dessì , 4 Roberta Pintus, 4 Vassilios Fanos, 4 and Gian Benedetto Melis 1 1 Department of Surgical Sciences, Division of Gynaecology and Obstetrics, University of Cagliari, Cagliari, Italy 2 Department of Chemical and Geological Sciences, University of Cagliari, Cagliari, Italy 3 Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy 4 Department of Surgical Sciences, Neonatal Intensive Care Unit, Puericulture Institute and Neonatal Section, Azienda Ospedaliera Universitaria, Cagliari, Italy 5 Laboratory Medicine Service, IRCCS AOU San Martino-IST, University-Hospital, Genoa, Italy 6 Maternal Neonatal Department, Division of Gynaecology and Obstetrics, Massa Carrara Hospital, Carrara, Italy Correspondence should be addressed to Claudia Fattuoni; cfattuon@unica.it Received 17 October 2017; Accepted 24 December 2017; Published 4 February 2018 Academic Editor: Vincent Sapin Copyright © 2018 Alessandra Meloni et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Since pathologies and complications occurring during pregnancy and/or during labour may cause adverse outcomes for both newborns and mothers, there is a growing interest in metabolomic applications on pregnancy investigation. In fact, metabolomics has proved to be an efficient strategy for the description of several perinatal conditions. In particular, this study focuses on premature rupture of membranes (PROM) in pregnancy at term. For this project, urine samples were collected at three different clinical conditions: out of labour before PROM occurrence (Ph1), out of labour with PROM (Ph2), and during labour with PROM (Ph3). GC-MS analysis, followed by univariate and multivariate statistical analysis, was able to discriminate among the different classes, highlighting the metabolites most involved in the discrimination. 1. Introduction The early diagnosis of pregnancy-related complications and the prediction of pregnancy outcome are considered strategic clinical goals to ensure the health of mothers and of their babies. Among these, premature rupture of membranes (PROM) consists of the rupture of the foetal membranes before the onset of labour. It can be observed at any gesta- tional age [1] and occurs in approximately 10% of pregnant women and in roughly 40% of preterm deliveries [2]. Foetal membranes are of pivotal importance because they offer a robust barrier against infection ascending from the repro- ductive tract; after their rupture, both the mother and foetus are at risk of infection and other complications. The most commonly diagnosed maternal infections in case of PROM are chorioamnionitis and endometritis, which may be further promoted by frequent vaginal exams and the presence of meconium in the amniotic fluid (AF) [3]. Foetal complica- tions of PROM include neonatal sepsis, abnormal foetal pre- sentation, cord prolapse or compression, and abruptio placentae, and these may increase the risk of neonatal intra- ventricular haemorrhage, leading to neurodevelopmental disability as a direct consequence [4]. Therefore, from PROM, diagnosis may derive different medical procedures such as hospitalization, antibiotic prophylaxis, and induction of labour through oxytocin [5, 6], that is, increased medical- ization and caesarean section rates. These practices may in turn affect several women in the positive experience of birth [7]. Moreover, given the increasing antibiotic resistance, alerts have been issued about the use and abuse of prophylac- tic antibiotic administration [8]. Indeed, growing evidences on this phenomenon suggest possible short- and long-term Hindawi Disease Markers Volume 2018, Article ID 1042479, 9 pages https://doi.org/10.1155/2018/1042479