Introduction Suspected preterm labour (SPL) is an obstetric complication that occurs in 9% of all pregnancies and is the leading cause of antenatal hospital admissions. More than half of women with SPL deliver a premature baby which is a known risk factor for developing cardiovascular and metabolic disorders in childhood and later in adult life. On the other hand, the other half of these women will deliver at term, labelled as ‘false preterm labour’. Although this has been thought to be a benign condition, accumulating evidence reported in recent years showed long-term effects for the foetus, neonate and infant even when birth occurs at term. However, the impact of SPL on cardiovascular and metabolic programming has not been studied yet. The aim of this prospective cohort study is to evaluate the impact of SPL on cardiac remodelling and function and on cardiovascular and metabolic profiles independently of gestational age at birth. Methods and analysis Prospective cohort study of subjects exposed and not exposed to an episode of SPL. Women with singleton pregnancies who are admitted at a tertiary hospital due to SPL and matched controls will be recruited. Evaluation of cardiovascular remodelling by foetal echocardiography will be performed during admission. Cord blood will be collected at birth in order to analyse different metabolomic footprints and several cardiovascular and metabolic risk biomarkers. Moreover, children will undergo an echocardiography 6 months after birth. The relationship between SPL and cardiovascular and metabolic programming will be modelled considering different covariates such as socioeconomic factors, perinatal characteristics, lifestyle, diet and exercise. Ethics and dissemination Ethical approval was granted in April 2020 from CEIC Aragón (CEICA) (C.P.-C.I. PI20/136). Study outcomes will be disseminated at international conferences and published in peer-reviewed scientific journals. Trial registration number NCT05670665.

Background: SARS-CoV-2 infection has been linked to an increased risk of hypertensive disorders during pregnancy, particularly preeclampsia (PE). As both conditions involve vascular and endothelial dysfunction, a mechanistic overlap has been proposed. This study examines the relationship between maternal COVID-19 and preeclampsia by analyzing inflammatory, endothelial, and angiogenic biomarkers in pregnancies with and without these complications. Methods: A case–control study was conducted, including four groups: healthy pregnancies before 2020 (n = 10), preeclampsia cases before 2020 (n = 10), COVID-19 cases without preeclampsia (n = 10), and COVID-19 cases with preeclampsia (n = 10). The groups were selected to be comparable in terms of gestational age at blood sampling. Biomarkers related to endothelial, inflammatory, and angiogenic pathways were measured. Results: Significant differences in biomarker levels were detected among the four groups. Regarding endothelial damage, sICAM1 levels were significantly higher in the COVID-PE group compared with the COVID-noPE group (p = 0.002). Additionally, vWF (p = 0.006), END1 (p < 0.001), and sVCAM1 (p = 0.030) levels varied significantly across groups. IL8 levels showed significant differences (p < 0.001), and were particularly elevated in preeclampsia cases (preCOVID-PE and COVID-PE groups) compared with controls (p = 0.005 and p < 0.001, respectively). Angiogenic markers sFlt-1, PLGF, and sFlt-1/PLGF exhibited significant group differences (p < 0.001). In contrast, maternal SARS-CoV-2 infection in the absence of preeclampsia was not associated with a significant alteration of the sFlt-1/PlGF ratio. Discussion: PE associated with SARS-CoV-2 infection preserved the classical angiogenic signature of preeclampsia, but showed additional endothelial and inflammatory biomarker alterations. These findings support an association between SARS-CoV-2 infection and a distinct endothelial and inflammatory biomarker profile in PE, warranting confirmation in larger prospective studies.

Objective: To characterize the cord blood metabolic profile of infants born after suspected preterm labor (sPTL) according to whether delivery occurred preterm or at term compared with infants from uncomplicated pregnancies. Study Design: Prospective observational cohort study including singleton pregnancies complicated by sPTL and uncomplicated pregnancies. Lipid‐inclusive metabolomics was performed by liquid chromatography–mass spectrometry (LC–MS), and data were analyzed using multivariate and univariate approaches. Results: Of 507 detected metabolites, 506 were present in at least 70% of samples and were included in the analysis. Multivariate analyses showed separation between sPTL with preterm delivery and uncomplicated controls, whereas sPTL with term delivery showed an intermediate metabolic profile. Univariate analysis identified 122 metabolites that differed across the three groups after Benjamini–Hochberg correction. The metabolites contributing most strongly to group discrimination were predominantly lipids, including phosphatidylcholines, cholesteryl esters, sphingomyelins, lysophosphatidylethanolamine, and cholesterol‐derived hormones. Hierarchical clustering of the top 25 metabolites identified three clusters, with most sPTL pregnancies resulting in term delivery falling within an intermediate cluster. As antenatal corticosteroid exposure was common among pregnancies with sPTL, and as the sample size of the non‐exposed subgroup was limited, the study could not reliably disentangle the effects of sPTL from those of corticosteroid treatment. Conclusion: Cord blood metabolomic profiles differed between infants from pregnancies complicated by sPTL and infants from uncomplicated term pregnancies. The persistence of an intermediate metabolic profile among infants born at term after sPTL raises the possibility of a metabolic signature associated with the preceding episode of sPTL. However, the observational design and frequent antenatal corticosteroid exposure preclude the attribution of these differences specifically to sPTL. Larger studies with adequate representation of corticosteroid‐exposed and non‐exposed pregnancies are warranted.