Elabela is a reliable biomarker for predicting early onset preeclampsia: A comparative study.

BACKGROUND: Preeclampsia (PE) is a multisystemic metabolic disease with an undetermined etiology. PE is a worldwide cause of maternal and perinatal morbidity, subdivided into early (EoPE) and late-onset (LoPE) according to 34 wk of gestation as a divider. Many researchers investigated biomarkers for predicting PE to halt its consequences on the feto-maternal outcome. Elabela (Ela) is a newly discovered peptide hormone that was implicated in PE pathogenesis. Earlier rodent studies discussed Ela's role in controlling blood pressure. Moreover, Ela deficiency was associated with PE development. AIM: To test whether plasma Ela could serve as a reliable marker for predicting PE based on the time of onset (EoPE vs LoPE) compared to age and body mass matched healthy controls since no definitive treatment exists for PE but to terminate a pregnancy. METHODS: This case-control study recruited (n = 90) pregnant who fulfilled inclusion criteria; they were allocated into three groups: EoPE (30/90) (< 34 wk of gestation); LoPE (30/90) (≥ 34 wk of gestation); and healthy pregnant (30/90). Demographic criteria; biochemical, hematological, and maternal plasma Ela levels were recorded for comparison. RESULTS: Serum Ela was significantly reduced in EoPE compared to LoPE and healthy controls (P = 0.0023). The correlation confirmed a strong inverse relationship with mean atrial blood pressure (r = -0.7, P < 0.001), while gestational age and platelets count showed a moderate correlation with (r = 0.4 with P < 0.0001). No correlation was confirmed between the body mass index (BMI) and urine albumin. The predictive ability of 25 centile serum Ela had an Odds ratio of 5.21, 95% confidence interval (1.28, 21.24), P = 0.02 for predicting EoPE. The receiver operator characteristic curve defined the Ela cutoff value at > 9.156 with 96.7% and 93.3% sensitivity and specificity, P < 0.0001 in predicting EoPE. CONCLUSION: A strong correlation of serum Ela with PE parameters with excellent sensitivity and specificity in distinguishing EoPE independent of the BMI, age, and blood pressure which makes Ela a recommendable marker in screening. Further research is warranted to explore prognostic and therapeutic applications for Ela in PE.

The value of Neutrophil gelatinase-associated lipocalin and Neutrophil / Lymphocyte Ratio in the diagnosis of preeclampsia and its severity.

Many hypotheses underlie the pathogenesis of preeclampsia. This study aims to evaluate Neutrophil gelatinase-associated lipocalin (a marker of immune hypothesis) and Neutrophil / Lymphocyte ratio (a marker of inflammation) in the diagnosis of preeclampsia and its severity and to determine the correlation between them.Study design : This randomized case-control study involved 132 pregnant women ; 88 were diagnosed with PE (divided into non-severe and severe groups), and 44 healthy pregnant women as a control group. Results : The mean serum level of NGL was significantly higher in PE (535.37 ±â€…158.61 ng / ml for severe PE, 522.5 ±â€…106.3 ng / ml for non-severe PE, and 161.96 ±â€…17.48 ng / ml for the control group). The ROC Curve NGL criteria of more than 204.4 ng / ml showed 100% sensitivity and specificity in both severe and non-severe cases versus control. The N / L ratio showed a significant difference (5.81 ±â€…5.24 for severe PE, 4.1 ±â€…3.41 for non-severe PE, and 3.89 ±â€…1.79 for the control group), but the ROC curve criterion was not significant. Both showed a non-significant positive correlation. Conclusion : NGL is an excellent diagnostic factor, whereas N / L might have lower diagnostic performance compared with NGL. Both are related independently to the pathophysiology of PE. J. Med. Invest. 68 : 321-325, August, 2021.

Maternal platelets in missed abortion; from a clinical perspective.

OBJECTIVE: To assess the significance of platelet indices, mean platelet volume, and platelet distribution width in patients with missed abortion as an earlier and cost-benefit screening test. METHODS: The prospective case-control study was conducted at the University Hospital, Baghdad, Iraq, from April to September 2021, and comprised women with missed abortion as well as healthy controls. Anthropometric parameters were recorded alongside complete blood count, platelet count, mean platelet volume, and platelet distribution width were evaluated and compared between the two groups. Data was analysed using Medcalc 20. RESULTS: Of the 60 subjects, 30(50%) were cases with a mean age of 27.8±6.1 years, and 30(50%) were healthy controls with a mean age of 25.7±5.2 years (P>0.05). All platelets parameters were significantly high among the cases compared to the controls (P<0.05). CONCLUSION: Platelet distribution width was found to have the highest sensitivity in predicting missed abortion.