Evaluation of Maternal Serum ELABELA Levels in Pregnancies Diagnosed With Abortus Imminens Between 8 and 14 Weeks of Gestation.

AIM: Abortus imminens is a common condition in early pregnancy characterized by vaginal bleeding with a closed cervix and viable intrauterine pregnancy. Current biochemical markers have limited accuracy in predicting pregnancy outcomes. ELABELA (also known as Apela or Toddler), a peptide involved in angiogenesis and placental development, may serve as a potential biomarker in early pregnancy complications. This study aimed to evaluate maternal serum ELABELA levels in pregnancies diagnosed with abortus imminens.

METHODS

This prospective cross-sectional study included 45 pregnant women diagnosed with abortus imminens between 8 and 14 weeks of gestation and 45 healthy controls. Maternal serum ELABELA levels were measured using enzyme-linked immunosorbent assay (ELISA). All serum samples were analyzed simultaneously in a single analytical batch to minimize interassay variability. Statistical analyses included group comparisons, receiver operating characteristic (ROC) curve analysis, and binary logistic regression.

RESULTS

There were no significant differences between groups in terms of age, body mass index (BMI), gestational age at sampling, gravidity, or parity (p > 0.05). ELABELA levels were significantly lower in the abortus imminens group compared with controls (median: 649.82 vs. 859.60 pg/mL; p = 0.021). ROC analysis demonstrated modest discriminative ability (area under the curve [AUC] = 0.641; 95% confidence interval [CI]: 0.520-0.751), with an optimal cut-off value of 712.0 pg/mL (sensitivity 60.0%, specificity 68.9%). Logistic regression analysis showed no independent predictive value for ELABELA.

CONCLUSION

Maternal serum ELABELA levels are significantly reduced in pregnancies with abortus imminens, suggesting a potential role in early placental dysfunction. Although ELABELA alone may not be a strong independent predictor, it may serve as a complementary biomarker in the evaluation of abortus imminens. Further large-scale prospective studies are needed to confirm these findings.