Multi-Omics for Mothers and Infants (MOMI) Consortium: a global initiative to study adverse pregnancy outcomes

Background: The Multi-Omics for Mothers and Infants (MOMI) Consortium aims to define biological mechanisms associated with preterm birth, small for gestational age, preeclampsia, and stillbirth. Globally, the burden of adverse pregnancy outcomes (APOs) is highest in low- and middle-income countries (LMICs). The MOMI Consortium consists of six different LMIC sites established by The Alliance for Maternal and Newborn Health Improvement in Bangladesh, Pakistan, and Tanzania, the Global Alliance to Prevent Prematurity and Stillbirth in Bangladesh and Zambia, and the Interdisciplinary Group for Advanced Research on Birth Outcomes - DBT India Initiative. It also partners with five analytical partners and three bioinformatic teams. Methods: The combined MOMI cohort includes 24 321 pregnant women, a rich biorepository, and paired socioeconomic and clinical data. Considering the multifactorial aetiologies and molecular drivers of APOs, we applied an integrative multi-omics (genomics, metabolomics, proteomics, nutrient testing) approach to identify site-specific and cohort-wide signatures linked to distinct APOs. Conclusions: This protocol summarises the MOMI study design, sample and data collection methods, data harmonisation, and the various analytics platforms, and discusses potential outcomes for enhanced clinical care and novel diagnostic and therapeutic tools.