Pregnancy and postpartum dynamics revealed by millions of lab tests

Pregnancy and delivery involve dynamic alterations in many physiological
systems. However, the physiological dynamics during pregnancy and after
delivery have not been systematically analyzed at high temporal resolution
in a large human population. Here we present the dynamics of 76 lab tests
based on a cross-sectional analysis of roughly 41 million measurements
from over 300,000 pregnancies. We analyzed each test at weekly intervals
from 20 weeks preconception to 80 weeks postpartum, providing detailed
temporal profiles. About half of the tests take three months to a year to
return to baseline during postpartum, highlighting the physiologic load of
childbirth. The precision of the data revealed the effects of
preconception supplements, overshoots after delivery, and intricate
temporal responses to changes in blood volume and renal filtration rate.
Pregnancy complications – gestational diabetes, pre-eclampsia, and
postpartum hemorrhage – showed distinct dynamical changes. These results
provide a comprehensive dynamic portrait of the systems physiology of
pregnancy.

妊娠与分娩过程会对诸多生理系统造成动态改变。然而，目前尚未针对大规模人群，以高时间分辨率对妊娠期间及产后的生理动态变化开展系统性分析。本研究基于对超过30万例妊娠案例的约4100万条检测数据开展的横断面分析，呈现了76项实验室检测指标的动态变化特征。我们从孕前20周至产后80周，以周为时间间隔对每项检测指标进行分析，由此得到了详尽的时间分布特征。约半数检测指标需耗时3个月至1年才能在产后恢复至基线水平，这凸显了分娩带来的生理负荷。得益于数据的高精度，本研究揭示了孕前补充剂的影响、产后指标超调现象，以及机体对血容量与肾滤过率变化的复杂时间响应模式。妊娠并发症——包括妊娠糖尿病、子痫前期与产后出血——均呈现出独特的动态变化特征。本研究结果全面描绘了妊娠相关系统生理学的动态图景。