Serum activin B concentration as predictive biomarker for ectopic pregnancy

Area of Science:

• Reproductive Endocrinology
• Clinical Diagnostics
• Biomarker Discovery

Background:

• Early and accurate diagnosis of pregnancy complications is crucial.
• Tubal ectopic pregnancy (tEP) poses significant health risks.
• Distinguishing tEP from normal intrauterine pregnancy (IUP) and intrauterine miscarriage (IUM) is clinically challenging.

Purpose of the Study:

• To assess the diagnostic accuracy of serum activin B in differentiating tEP from IUM and normal IUP.
• To compare the efficacy of activin B with free beta-human chorionic gonadotropin (β-hCG) in diagnosing tEP.
• To evaluate the combined diagnostic potential of activin B and free β-hCG.

Main Methods:

• Serum activin B concentrations were measured using ELISA in 28 women with tEP, 31 with IUM, and 29 with normal IUP.
• Diagnostic accuracy was evaluated using Receiver Operating Characteristic (ROC) curve analysis.
• Activin B, free β-hCG, and their combination were analyzed for discriminating capabilities.

Main Results:

• Serum activin B levels were significantly lower in both tEP (p=0.004) and IUM (p=0.022) compared to normal IUP.
• Activin B showed moderate accuracy (AUC=0.722) in discriminating tEP from viable IUP.
• The combination of activin B and free β-hCG improved discrimination of tEP from viable IUP (AUC=0.824, specificity=93%).
• Activin B, free β-hCG, and their combination performed poorly in distinguishing tEP from IUM.

Conclusions:

• Serum activin B is a potential biomarker for identifying tubal ectopic pregnancy, showing reduced levels compared to normal intrauterine pregnancies.
• Activin B, particularly when combined with free β-hCG, enhances the diagnostic accuracy for differentiating tubal ectopic pregnancy from normal intrauterine pregnancy.
• Current evidence suggests activin B is not a reliable standalone marker or in combination with free β-hCG for differentiating tubal ectopic pregnancy from intrauterine miscarriage.