Precision fetal cardiology detects cyanotic congenital heart disease using maternal saliva metabolome and artificial intelligence

Abstract Prenatal sonographic diagnosis of congenital heart disease (CHD) can lead to improved morbidity and mortality. However, the diagnostic accuracy of ultrasound, the sole prenatal screening tool, remains limited. Failed prenatal or early newborn detection of cyanotic CHD (CCHD) can have disast...

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Main Authors: Ray Bahado-Singh, Nadia Ashrafi, Amin Ibrahim, Buket Aydas, Ali Yilmaz, Perry Friedman, Stewart F. Graham, Onur Turkoglu
Format: Article
Language:English
Published: Nature Portfolio 2025-01-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-025-85216-7
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author Ray Bahado-Singh
Nadia Ashrafi
Amin Ibrahim
Buket Aydas
Ali Yilmaz
Perry Friedman
Stewart F. Graham
Onur Turkoglu
author_facet Ray Bahado-Singh
Nadia Ashrafi
Amin Ibrahim
Buket Aydas
Ali Yilmaz
Perry Friedman
Stewart F. Graham
Onur Turkoglu
author_sort Ray Bahado-Singh
collection DOAJ
description Abstract Prenatal sonographic diagnosis of congenital heart disease (CHD) can lead to improved morbidity and mortality. However, the diagnostic accuracy of ultrasound, the sole prenatal screening tool, remains limited. Failed prenatal or early newborn detection of cyanotic CHD (CCHD) can have disastrous consequences. We therefore sought to use a Precision Fetal Cardiology based approach combining metabolomic profiling of maternal saliva and machine learning, a major branch of artificial intelligence (AI), for the prenatal detection of isolated, non-syndromic cyanotic CHD. Metabolomic analyses using Ultra-High Performance Liquid Chromatography/Mass Spectrometry identified 468 metabolites in the saliva. Six different AI platforms were utilized for the detection of CCHD and CHD overall. AI achieved excellent accuracy for the CCHD detection: Area Under the ROC curve: AUC (95% CI) = 0.819 (0.635-1.00) with a sensitivity and specificity of 92.5% and 87.0%, and for CHD overall: AUC (95% CI) = 0.828 (0.635-1.00) with a sensitivity of 90.5% and specificity of 88.0%. Similarly high accuracies were achieved for the detection of CHD overall: AUC (95% CI) = 0.8488 (0.635-1.00) with a sensitivity of 92.5% and specificity of 91.0%. Pathway analysis showed significant alterations in Arachidonic Acid, Alpha-linoleic acid, and Tryptophan metabolism indicating significant lipid dysfunction in cyanotic CHD. In summary, we report for the first time, the accurate detection of non-syndromic cyanotic CHD using maternal salivary metabolomics. Further, analysis revealed significant alteration of lipid metabolism.
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spelling doaj-art-26e4a578ebb9411ea42261f5ed8ab2fb2025-01-19T12:23:38ZengNature PortfolioScientific Reports2045-23222025-01-0115111110.1038/s41598-025-85216-7Precision fetal cardiology detects cyanotic congenital heart disease using maternal saliva metabolome and artificial intelligenceRay Bahado-Singh0Nadia Ashrafi1Amin Ibrahim2Buket Aydas3Ali Yilmaz4Perry Friedman5Stewart F. Graham6Onur Turkoglu7Department of Obstetrics and Gynecology, Corewell Health William Beaumont University Hospital, Oakland University William Beaumont School of MedicineMetabolomics Department, Corewell Health William Beaumont University Hospital, Beaumont Research InstituteMetabolomics Department, Corewell Health William Beaumont University Hospital, Beaumont Research InstituteDepartment of Care Management Analytics, Blue Cross Blue Shield of MichiganMetabolomics Department, Corewell Health William Beaumont University Hospital, Beaumont Research InstituteDepartment of Obstetrics and Gynecology, Corewell Health William Beaumont University Hospital, Oakland University William Beaumont School of MedicineDepartment of Obstetrics and Gynecology, Corewell Health William Beaumont University Hospital, Oakland University William Beaumont School of MedicineDepartment of Obstetrics and Gynecology, Baylor College of Medicine, Texas Children’s HospitalAbstract Prenatal sonographic diagnosis of congenital heart disease (CHD) can lead to improved morbidity and mortality. However, the diagnostic accuracy of ultrasound, the sole prenatal screening tool, remains limited. Failed prenatal or early newborn detection of cyanotic CHD (CCHD) can have disastrous consequences. We therefore sought to use a Precision Fetal Cardiology based approach combining metabolomic profiling of maternal saliva and machine learning, a major branch of artificial intelligence (AI), for the prenatal detection of isolated, non-syndromic cyanotic CHD. Metabolomic analyses using Ultra-High Performance Liquid Chromatography/Mass Spectrometry identified 468 metabolites in the saliva. Six different AI platforms were utilized for the detection of CCHD and CHD overall. AI achieved excellent accuracy for the CCHD detection: Area Under the ROC curve: AUC (95% CI) = 0.819 (0.635-1.00) with a sensitivity and specificity of 92.5% and 87.0%, and for CHD overall: AUC (95% CI) = 0.828 (0.635-1.00) with a sensitivity of 90.5% and specificity of 88.0%. Similarly high accuracies were achieved for the detection of CHD overall: AUC (95% CI) = 0.8488 (0.635-1.00) with a sensitivity of 92.5% and specificity of 91.0%. Pathway analysis showed significant alterations in Arachidonic Acid, Alpha-linoleic acid, and Tryptophan metabolism indicating significant lipid dysfunction in cyanotic CHD. In summary, we report for the first time, the accurate detection of non-syndromic cyanotic CHD using maternal salivary metabolomics. Further, analysis revealed significant alteration of lipid metabolism.https://doi.org/10.1038/s41598-025-85216-7
spellingShingle Ray Bahado-Singh
Nadia Ashrafi
Amin Ibrahim
Buket Aydas
Ali Yilmaz
Perry Friedman
Stewart F. Graham
Onur Turkoglu
Precision fetal cardiology detects cyanotic congenital heart disease using maternal saliva metabolome and artificial intelligence
Scientific Reports
title Precision fetal cardiology detects cyanotic congenital heart disease using maternal saliva metabolome and artificial intelligence
title_full Precision fetal cardiology detects cyanotic congenital heart disease using maternal saliva metabolome and artificial intelligence
title_fullStr Precision fetal cardiology detects cyanotic congenital heart disease using maternal saliva metabolome and artificial intelligence
title_full_unstemmed Precision fetal cardiology detects cyanotic congenital heart disease using maternal saliva metabolome and artificial intelligence
title_short Precision fetal cardiology detects cyanotic congenital heart disease using maternal saliva metabolome and artificial intelligence
title_sort precision fetal cardiology detects cyanotic congenital heart disease using maternal saliva metabolome and artificial intelligence
url https://doi.org/10.1038/s41598-025-85216-7
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