Is ELABELA a reliable biomarker for hypertensive disorders of pregnancy?

We aimed to examine the ELABELA levels at different stages of pregnancy among normotensive controls and women with hypertensive disorders of pregnancy (HDP).

A total of 336 blood samples of 169 women were collected from pre-pregnancy, the first, second, and third trimesters. Women were divided into the following six groups: 1) non-pregnant healthy women; 2) healthy pregnant controls; 3) chronic hypertension; 4) gestational hypertension; 5) preeclampsia; and 6) preeclampsia superimposed on chronic hypertension. ELABELA plasma concentrations were measured by human ELA Elisa Kit (Peninsula Laboratories International, Inc. USA). Kruskal-Wallis test was used to test whether ELABELA level in each type of HDP differed from that in gestational week-matched normotensive controls.

Hypertensive disorders of pregnancy.

In the first trimester, patients with gestational hypertension had higher ELABELA level than gestational week-matched normotensive controls [median (ng/ml): 31.9, (IQR (ng/ml): 16.3, 47.6) vs. 19.7 (13.7, 23.2), p = 0.03]. In the second trimester, the levels were 49.2 (32.2, 69.1) vs 24.0 (13.0, 32.6) (p = 0.002), respectively. The level for gestational hypertensive women in the third trimester did not differ significantly from that of normotensive women [43.8 (30.8, 62.7) vs 25.0 (12.3, 74.0), p = 0.82]. The ELABELA levels were similar between preeclamptic women and normotensive controls throughout pregnancy.

Maternal blood ELABELA levels in the first and second trimesters were elevated in women who developed gestational hypertension late in pregnancy, but the ELABELA level bears no significant relationship with preeclampsia during any stage of pregnancy.