Maternal serum adropin as a potential biomarker for placenta accreta spectrum: a cross-sectional study

Adropin is a regulatory peptide implicated in endothelial homeostasis, and reduced circulating levels have been linked to endothelial dysfunction and impaired vascular remodeling. This study aimed to compare maternal serum adropin levels in pregnancies complicated by placenta previa and/or placenta accreta spectrum (PAS) with those of healthy pregnant women and to evaluate the discriminative performance of adropin for abnormal placental invasion.

This cross-sectional study included 84 singleton pregnancies at ≥ 34 weeks of gestation: 42 women diagnosed with placenta previa and/or PAS and 42 healthy pregnant women who underwent cesarean delivery. Maternal preoperative serum adropin concentrations were quantified using a commercially available enzyme-linked immunosorbent assay (ELISA). Demographic, obstetric, ultrasonographic, and intraoperative findings were recorded. Receiver operating characteristic (ROC) curve analysis was performed to assess the discriminative ability of serum adropin levels for abnormal placental invasion.

A total of 84 pregnant women were included in the study: 42 healthy controls, 30 patients with placenta previa without PAS, and 12 patients diagnosed with PAS. Maternal serum adropin concentrations were significantly reduced in pregnancies complicated by placenta previa and/or PAS compared with healthy controls (p < 0.001). No significant differences were observed between groups in terms of body mass index or routine laboratory parameters. ROC analysis demonstrated moderate discriminative performance, with an area under the curve of 0.778 (p < 0.001). An adropin cut-off value of ≤431.27 pg/mL yielded a sensitivity of 71.4% and a specificity of 78.6%.

Maternal serum adropin levels are significantly reduced in pregnancies complicated by placenta previa and/or PAS. Decreased adropin concentrations may reflect a disturbed metabolic-endothelial milieu associated with abnormal placental invasion. Adropin may serve as a supportive biomarker; however, findings should be interpreted cautiously given the cross-sectional design. Further prospective studies are required to clarify its potential clinical utility.