open access
Elabela levels in pregnancies with intrauterine growth retardation
, 2, 3, 2, 4, 3, 5, 6
Affiliations- Department of Obstetrics and Gynecology, Tuzla State Hospital, Tuzla, Istanbul, Turkey, Türkiye
- Firat University, School of Medicine, Department of Obstetrics and Gynecology, Elazig, Turkey
- Department of Obstetrics and Gynecology, Fethi Sekin City Hospital, Fethi Sekin City Hospital, Elazig, Turkey, Türkiye
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Balikesir University, Balikesir, Turkey, Türkiye
- Department of Obstetrics and Gynecology, Hani State Hospital, Hani State Hospital, Diyarbakir, Turkey, Türkiye
- Department of Obstetrics and Gynecology, Kovancılar State Hospital, Kovancılar State Hospital, Elazig, Turkey, Türkiye
open access
Abstract
Objectives: The aim of our study is to examine maternal serum Elabela levels in pregnancy with intrauterine growth retardation (IUGR). IUGR is one of the most important causes of perinatal mortality and morbidity. IUGR is also related future comorobidities such as diabetes mellitus, hyperlipidemia, hypertension and coronary artery disease.
Material and methods: Fifty pregnancies diagnosed as IUGR (Group 1) and fifty healthy pregnancies (Group 2) enrolled into the study. Obstetric and demographic characteristics of the patients, serum elabela levels, ultrasound parameters, cord pH value and APGAR scores of the newborns were recorded. In the study, which was planned as a prospective case-control study, an independent t test was used for the evaluation of continuous data and the Mann Whitney U test was used for the statistical evaluation of ordinal data. p < 0.05 was considered significant.
Results: The mean gestational age of the cases at delivery was 36.35 ± 1.29 in Group 1 and 38.16 ± 0.94 weeks in Group 2 (p < 0.05). Mean serum Elabela levels were 15.05 ± 9.03 in Group 1 and 8.96 ± 4.33 ng/mL in Group 2 (p < 0.0001). Mean newborn weights were 2498.20 ± 465.92 in Group 1 and 3179.44 ± 387.99 gr. in Group 2 (p < 0.0001). Systolic and diastolic blood pressure measurements taken on the day of delivery were higher in Group 1, and diastolic blood pressure was 77.0 ± 9.53 in Group 1 and 72.60 ± 13.37 mmHg in Group 2 (p < 0.05). Bilateral uterine artery Pulsatile Index (PI) and umbilical artery PI value were significantly higher in Group 1 (p < 0.05), and middle cerebral artery PI and cerebroplacental ratio were significantly lower in Group 1 compared to Group 2 (p < 0.05). Although the cord pH value, 1st and 5th minute APGAR scores were lower in Group 1 compared to Group 2, no statistically significant difference was found (p > 0.05).
Conlusions: In our study, it was found that serum Elabela levels increased significantly in pregnancies complicated by IUGR compared to the control group.
Abstract
Objectives: The aim of our study is to examine maternal serum Elabela levels in pregnancy with intrauterine growth retardation (IUGR). IUGR is one of the most important causes of perinatal mortality and morbidity. IUGR is also related future comorobidities such as diabetes mellitus, hyperlipidemia, hypertension and coronary artery disease.
Material and methods: Fifty pregnancies diagnosed as IUGR (Group 1) and fifty healthy pregnancies (Group 2) enrolled into the study. Obstetric and demographic characteristics of the patients, serum elabela levels, ultrasound parameters, cord pH value and APGAR scores of the newborns were recorded. In the study, which was planned as a prospective case-control study, an independent t test was used for the evaluation of continuous data and the Mann Whitney U test was used for the statistical evaluation of ordinal data. p < 0.05 was considered significant.
Results: The mean gestational age of the cases at delivery was 36.35 ± 1.29 in Group 1 and 38.16 ± 0.94 weeks in Group 2 (p < 0.05). Mean serum Elabela levels were 15.05 ± 9.03 in Group 1 and 8.96 ± 4.33 ng/mL in Group 2 (p < 0.0001). Mean newborn weights were 2498.20 ± 465.92 in Group 1 and 3179.44 ± 387.99 gr. in Group 2 (p < 0.0001). Systolic and diastolic blood pressure measurements taken on the day of delivery were higher in Group 1, and diastolic blood pressure was 77.0 ± 9.53 in Group 1 and 72.60 ± 13.37 mmHg in Group 2 (p < 0.05). Bilateral uterine artery Pulsatile Index (PI) and umbilical artery PI value were significantly higher in Group 1 (p < 0.05), and middle cerebral artery PI and cerebroplacental ratio were significantly lower in Group 1 compared to Group 2 (p < 0.05). Although the cord pH value, 1st and 5th minute APGAR scores were lower in Group 1 compared to Group 2, no statistically significant difference was found (p > 0.05).
Conlusions: In our study, it was found that serum Elabela levels increased significantly in pregnancies complicated by IUGR compared to the control group.
Keywords
pregnancy; intrauterine growth retardation; Elabela
About this articleTitle
Elabela levels in pregnancies with intrauterine growth retardation
Journal
Issue
Article type
Research paper
Pages
113-118
Published online
2022-03-07
Page views
2970
Article views/downloads
630
DOI
Pubmed
Bibliographic record
Ginekol Pol 2023;94(2):113-118.
Keywords
pregnancy
intrauterine growth retardation
Elabela
Authors
Gulen Yener
Salih Burçin Kavak
Yeliz Gul
Ebru Celik Kavak
Funda Gulcu Bulmus
Cengiz Sanli
Ibrahim Batmaz
Gulay Bulu
References (34)- Gardosi J, Chang A, Kalyan B, et al. Customised antenatal growth charts. Lancet. 1992; 339(8788): 283–287.
- ACOG Practice Bulletin No. 204 Summary: Fetal Growth Restriction. Obstet Gynecol. 2019; 133(2): 390–392.
- Regev R, Lusky A, Dolfin T, et al. Excess mortality and morbidity among small-for-gestational-age premature infants: a population-based study. The Journal of Pediatrics. 2003; 143(2): 186–191.
- Barker DJP, Eriksson JG, Forsén T, et al. Fetal origins of adult disease: strength of effects and biological basis. Int J Epidemiol. 2002; 31(6): 1235–1239.
- Alfirevic Z, Neilson JP. Doppler ultrasonography in high-risk pregnancies: systematic review with meta-analysis. Am J Obstet Gynecol. 1995; 172(5): 1379–1387.
- Turan S, Turan OM, Berg C, et al. Computerized fetal heart rate analysis, Doppler ultrasound and biophysical profile score in the prediction of acid-base status of growth-restricted fetuses. Ultrasound Obstet Gynecol. 2007; 30(5): 750–756.
- Panaitescu B, Romero R, Gomez-Lopez N, et al. ELABELA plasma concentrations are increased in women with late-onset preeclampsia. J Matern Fetal Neonatal Med. 2020; 33(1): 5–15.
- Akcılar R, Turgut S, Caner V, et al. The effects of apelin treatment on a rat model of type 2 diabetes. Adv Med Sci. 2015; 60(1): 94–100.
- A randomised trial of timed delivery for the compromised preterm fetus: short term outcomes and Bayesian interpretation. BJOG: An International Journal of Obstetrics and Gynaecology. 2003; 110(1): 27–32.
- Kang Y, Kim J, Anderson JP, et al. Apelin-APJ signaling is a critical regulator of endothelial MEF2 activation in cardiovascular development. Circ Res. 2013; 113(1): 22–31.
- Scott IC, Masri B, D'Amico LA, et al. The g protein-coupled receptor agtrl1b regulates early development of myocardial progenitors. Dev Cell. 2007; 12(3): 403–413.
- Zeng XXI, Wilm TP, Sepich DS, et al. Apelin and its receptor control heart field formation during zebrafish gastrulation. Dev Cell. 2007; 12(3): 391–402.
- Kasai A, Shintani N, Kato H, et al. Retardation of retinal vascular development in apelin-deficient mice. Arterioscler Thromb Vasc Biol. 2008; 28(10): 1717–1722.
- Cekmez F, Pirgon O, Aydemir G, et al. Correlation between cord blood apelin and IGF-1 levels in retinopathy of prematurity. Biomark Med. 2012; 6(6): 821–825.
- Devic E, Rizzoti K, Bodin S, et al. Amino acid sequence and embryonic expression of msr/apj, the mouse homolog of Xenopus X-msr and human APJ. Mech Dev. 1999; 84(1-2): 199–203.
- Helker C, Schuermann A, Pollmann C, et al. The hormonal peptide Elabela guides angioblasts to the midline during vasculogenesis. eLife. 2015; 4.
- Levine RJ, Maynard SE, Qian C, et al. Circulating angiogenic factors and the risk of preeclampsia. N Engl J Med. 2004; 350(7): 672–683.
- Levine RJ, Lam C, Qian C, et al. CPEP Study Group. Soluble endoglin and other circulating antiangiogenic factors in preeclampsia. N Engl J Med. 2006; 355(10): 992–1005.
- Yamaleyeva LM, Chappell MC, Brosnihan KB, et al. Downregulation of apelin in the human placental chorionic villi from preeclamptic pregnancies. Am J Physiol Endocrinol Metab. 2015; 309(10): E852–E860.
- Colcimen N, Bulut G, Ergul Erkec O, et al. Investigation of role of vascular endothelial growth factor, Annexin A5 and Apelin by immunohistochemistry method in placenta of preeclampsia patients. Cell Mol Biol (Noisy-le-grand). 2017; 63(11): 42–45.
- Van Mieghem T, Doherty A, Baczyk D, et al. Apelin in normal pregnancy and pregnancies complicated by placental insufficiency. Reprod Sci. 2016; 23(8): 1037–1043.
- Wysocka MB, Pietraszek-Gremplewicz K, Nowak D. The Role of Apelin in Cardiovascular Diseases, Obesity and Cancer. Front Physiol. 2018; 9: 557.
- Ho L, van Dijk M, Chye ST, et al. ELABELA deficiency promotes preeclampsia and cardiovascular malformations in mice. Science. 2017; 357(6352): 707–713.
- Villie P, Lefevre G, Arrestier R, et al. ELABELA concentration is not decreased in maternal plasma before the onset of preeclampsia. Am J Obstet Gynecol. 2019; 220(3): 284–285.
- Pritchard N, Kaitu'u-Lino TJ, Gong S, et al. ELABELA/APELA Levels Are Not Decreased in the Maternal Circulation or Placenta among Women with Preeclampsia. Am J Pathol. 2018; 188(8): 1749–1753.
- Longtine MS, Nelson DM. Placental dysfunction and fetal programming: the importance of placental size, shape, histopathology, and molecular composition. Semin Reprod Med. 2011; 29(3): 187–196.
- Uzan J, Carbonnel M, Piconne O, et al. Pre-eclampsia: pathophysiology, diagnosis, and management. Vasc Health Risk Manag. 2011; 7: 467–474.
- Figueras F, Gardosi J. Intrauterine growth restriction: new concepts in antenatal surveillance, diagnosis, and management. Am J Obstet Gynecol. 2011; 204(4): 288–300.
- Roberts DJ, Post MD. The placenta in pre-eclampsia and intrauterine growth restriction. J Clin Pathol. 2008; 61(12): 1254–1260.
- Behram M, Oğlak SC, Dağ İ. Circulating levels of Elabela in pregnant women complicated with intrauterine growth restriction. J Gynecol Obstet Hum Reprod. 2021; 50(8): 102127.
- Flood K, Unterscheider J, Daly S, et al. The role of brain sparing in the prediction of adverse outcomes in intrauterine growth restriction: results of the multicenter PORTO Study. Am J Obstet Gynecol. 2014; 211(3): 288.e1–288.e5.
- Deniz R, Baykus Y, Ustebay S, et al. Evaluation of elabela, apelin and nitric oxide findings in maternal blood of normal pregnant women, pregnant women with pre-eclampsia, severe pre-eclampsia and umbilical arteries and venules of newborns. J Obstet Gynaecol. 2019; 39(7): 907–912.
- Hart JM, Young BC. Strip of the month: intrauterine growth restriction with abnormal umbilical artery doppler studies. Neoreviews. 2019; 20(3): e161–e169.
- Novac MV, Iliescu DG, Tudorache S, et al. Ultrasound evaluation of fetal biometry and doppler parameters in the third trimester of pregnancy suspected of intrauterine growth restriction. . Curr Health Sci J . 2018; 44(1): 23–28.
