August 2026, Volume 4, Issue 8

Author

M. Aishwarya Vaishnavi, S. Prakash and T. Uma

Abstract

Background: Significant maternal and perinatal morbidity is associated with pre-eclampsia (PE), a multisystem hypertension disease of pregnancy. The endogenous ligand for the apelin receptor (APJ) and 32-amino acid peptide hormone ELABELA (ELA) is essential for both placental development and cardiovascular homeostasis. Serum ELABELA is assessed in this study as a predictive biomarker that distinguishes between early-onset and late-onset pre-eclampsia. Methods: Over the course of a year, from January 2022 to January 2023, an analytical cross-sectional study was carried out at Madras Medical College in Chennai. Ninety individuals were recruited: thirty with early-onset PE (EoPE, <34 weeks), thirty with late-onset PE (LoPE, ?34 weeks), and thirty normotensive pregnant women (controls). Sandwich ELISA was used to measure serum ELABELA. Additional parameters were total protein, random blood glucose, liver function tests, and renal function tests. SPSS v27.0 was used for statistical analysis, and the Kruskal-Wallis and Spearman correlation tests were used (p <0.05 was deemed significant). Results: EoPE (7.0 ± 0.584 pg/mL) and LoPE (11.5 ± 0.290 pg/mL) had significantly lower mean serum ELABELA than controls (18.0 ± 0.585 pg/mL) (p = <0.001). Serum creatinine (r = -0.695) and urea (r = -0.447) showed significant negative associations with ELABELA, while total protein (r = +0.557) showed a significant positive relationship. Conclusion: Serum ELABELA is downregulated in both pre-eclampsia phenotypes, with early-onset illness exhibiting a more pronounced suppression. These findings suggest that ELABELA is a promising circulating biomarker that may aid in the prediction and phenotypic categorisation of pre-eclampsia, warranting further evaluation in longitudinal studies.