Clinics in Mother and Child Health

Abstract

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

Antonio Ragusa*, Maria Matta, Denise Rinaldo and Alessandra Meloni

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 abnormal 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.

Published Date: 2023-10-31; Received Date: 2023-09-30