Assessment of Serum Angiopoietin-1 Levels During Early Stage of Missed Miscarriage

First-trimester missed miscarriage is a common complication of pregnancy that significantly impacts maternal health and healthcare services. Although fetal chromosomal anomalies constitute about half of these cases, the remaining unexplained causes mandate diagnostic investigations that explore various pathways, including angiogenesis and growth factors. One growth factor contributing to angiogenesis is Angiopoietin-1 (Ang-1).

This study aims to investigate the diagnostic role of serum levels of Ang-1 in the first trimester of missed miscarriage.

This case-control study involved 88 pregnant women, 44 with healthy viable pregnancies at 8-14 weeks of gestation (controls), and 44 women diagnosed with missed miscarriages via ultrasound (cases) at the same gestational age. Maternal serum Ang-1 levels were recorded for comparison. The ELISA technique measured Ang-1 levels.

This study revealed a statistically significant reduction in serum Ang-1 levels in missed miscarriage cases (635.75 ± 119.90 pg/mL), compared to normal pregnant women (977.13 ± 320.59 pg/mL). The cut-off point was ≤ 780.99 pg/mL, with moderate sensitivity (63.6%) and high specificity (97.9%) for distinguishing missed miscarriages from normal pregnancies. There was a strong positive correlation between Ang-1 and gestational age, suggesting a potential role of Ang-1 in normal pregnancies.

The study suggests a diagnostic role for Ang-1 in discriminating MM from healthy pregnancies owing to its high specificity, which reflects its role in placental development. Still, Ang-1's utility is hindered by its moderate sensitivity.