Pregnancy and postpartum dynamics revealed by an atlas of millions of lab tests

Abstract

AbstractPregnancy involves dynamic alterations in most physiological systems. Delivery initiates a transition to postpartum recovery, which similarly exhibits widespread dynamic changes. Physiological dynamics during pregnancy and after delivery have not been systematically analyzed at high temporal resolution in a large human population. Here, we present a dynamic atlas of 78 laboratory tests with weekly time resolution, spanning the period from 20 weeks pre-conception until 80 weeks postpartum, totaling 45 million measurements from over half a million pregnancies. Tests exhibited discontinuities and rebound effects after delivery, and showed extended recovery times of up to a year postpartum. The accuracy of the data revealed effects of preconception supplements and intricate temporal responses to changes in blood volume and renal filtration rate. The dynamical data allowed discrimination between distinct mechanistic models of adaptation in the thyroid axis. These results provide a comprehensive dynamic portrait of the systems physiology of pregnancy.