Gestational Dating at Birth by Metabolic Profile: Testing and Adaptation in African Settings and Added Benefits of Test

Investigator: Laura Jelliffe, PhD, MS
Sponsor: Bill & Melinda Gates Foundation

Location(s): Malawi; Uganda


Accurate gestational dating is a critical component of obstetric and newborn care. In the absence of early ultrasound, many clinicians rely on less accurate measures, such as last menstrual period or symphysis-fundal height during pregnancy, or Dubowitz scoring or the Ballard (or New Ballard) method at birth. These measures often underestimate or overestimate gestational age and can lead to misclassification of babies as born preterm, which has both short- and long-term clinical care and public health implications.

Researchers at UCSF have developed a metabolic algorithm that can be used to determine the gestational age of newborns, using a small amount of blood taken from the newborn’s heel. Using 35 metabolic markers collected as part of routine newborn screening, along with birth weight and hours at test, these investigators were able to identify term and preterm newborns with more than 95% accuracy in a cohort of more than 700,000 babies and assign a week of gestation within two weeks in approximately nine in ten newborns. the study has been awarded a prestigious GCE Phase II grant from the Foundation with additional funding support provided by the UCSF Preterm Birth Initiative-East Africa. This Phase II work will be conducted in Uganda and Malawi and will assess whether metabolic gestational dating of newborns is possible in these African settings. This work brings together a consortium of investigators from UCSF, UC San Diego, the University of Iowa, Harvard University, the University of Toronto, Makerere University in Uganda, and the University of Malawi.