Published online Jun 16, 2023. doi: 10.12998/wjcc.v11.i17.3993
Peer-review started: March 18, 2023
First decision: May 9, 2023
Revised: May 9, 2023
Accepted: May 15, 2023
Article in press: May 15, 2023
Published online: June 16, 2023
Preeclampsia (PE) is a multisystemic disease that can cause problems for both the mother and the baby. It can start early or late, depending on how far along the pregnancy is. Elabela (Ela) is a recently found peptide hormone that was linked to the development of PE. Since the only safe way to treat PE is to end a pregnancy, the goal of this study was to see if plasma Ela could be used as a reliable way to predict PE based on the time of onset.
Endogenous ligand for apelin (APJ) receptors is found in many different parts of the human body, and Ela is produced by the fetus and placenta during pregnancy. Ela has a number of roles in embryonic life. During embryonic life, it stops renal remodeling, angiogenesis, and vascular morphogenesis. Also, the Ela-APJ system is very important for the development of the heart and blood vessels in a fetus. It can lower the tone of the blood vessels by directly relaxing the blood vessels in the aorta. This lowers blood pressure.
To determine the reliability of Ela in predicting PE based on time of incidence early (EoPE) vs late (LoPE) in order to reduce PE-related morbidity.
In a case-control study, pregnant women were divided into three groups: EoPE (30/90) (< 34 wk of gestation), LoPE (30/90) (≥ 34 wk of gestation), and healthy pregnant (30/90). Demographic criteria were examined, as well as biochemical, hematological, and maternal plasma Ela levels.
Serum Ela was significantly reduced in EoPE compared to LoPE and healthy controls (P = 0.0023); Ela had a strong inverse relationship to mean atrial blood pressure (r = -0.7, P < 0.001), and a moderate correlation with gestational age and platelets count (r = 0.4, P < 0.0001. 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. Ela’s cutoff value (> 9.15) distinguished EoPE with 96.7% sensitivity, 93.3% specificity, and P < 0.0001.
Ela is a highly recommended marker in screening due to its high sensitivity and specificity in differentiating EoPE from other conditions such as body mass index, age, and blood pressure.
Ela’s specificity and sensitivity, independent of gestational age, body mass index, and mean arterial pressure, lend credence to Ela’s ability to predict. As an added bonus, the therapeutic use proposed by previous researchers may eventually reveal prognostic application for lowering CVS risk in postpartum women. Further study is required to verify its usefulness in clinical settings.