Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Diagnosis of Labor and Human Evolution: Why Is It so Difficult to Diagnose Labor in Humans? The Contribution of Metabolomics

Version 1 : Received: 15 January 2023 / Approved: 16 January 2023 / Online: 16 January 2023 (07:25:19 CET)

A peer-reviewed article of this Preprint also exists.

Ragusa A, Matta M, Rinaldo D, Meloni A (2023) Diagnosis of Labor and Human Evolution: Why is it so Difficult to Diagnose Labor in Humans? The Contribution of Metabolomics. Clinics Mother Child Health. S18:002. Ragusa A, Matta M, Rinaldo D, Meloni A (2023) Diagnosis of Labor and Human Evolution: Why is it so Difficult to Diagnose Labor in Humans? The Contribution of Metabolomics. Clinics Mother Child Health. S18:002.

Abstract

The difficulty in the clinical diagnosis of labor is due to an evolutionary mismatch. The ability to hide the signs and symptoms of labor is an evolutionary trait that was once advantageous, but became maladaptive due to environmental changes. Prospective diagnosis of labor is not possible with certainty using only clinical criteria; however, by analyzing the urinary metabolome of women in labor, this diagnosis is likely possible in all cases. In this review, we explain why the two methods (clinical and metabolomic) differ in efficacy and sensitivity, and we try to fit this difference into an evolutionary framework that explains these discrepancies considering evolutionary mismatch. The study of metabolomics allows the truth to emerge from the past, and the diffusion of metabolomic techniques and their application to clinical reality in the form of POC (Point of Care) could change the management of labor and childbirth in the future.

Keywords

evolutionary mismatch; diagnosis of labor; prospective diagnosis; cervical dilatation; uterine contractions; pain intensity; metabolomic.

Subject

Medicine and Pharmacology, Obstetrics and Gynaecology

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