“Clinical and diagnostic value of GDF-15 and β-hCG in first trimester pregnancy with threatened miscarriage and the short-term impact of hormonal support: a prospective study”

Background Threatened miscarriage affects pregnancies globally, necessitating reliable diagnostic markers. Growth differentiation factor 15 (GDF-15) is associated with adverse pregnancy outcomes, yet its diagnostic value and response to progesterone support remain unclear. This prospective study aimed to assess the diagnostic significance of GDF-15 levels in maternal serum during the first trimester of threatened miscarriage and evaluate the impact of progesterone-based hormonal support. The study included 120 pregnant women: 60 diagnosed with threatened miscarriage and 60 healthy controls. In the patient group, serum β-hCG and GDF-15 levels were measured before and after a two-week course of progesterone therapy, while the control group underwent a single measurement. Results Women with threatened miscarriage exhibited significantly lower mean serum β-hCG and GDF-15 levels compared to the control group. Following progesterone therapy, GDF-15 levels in the patient group showed no significant change ( p = 0.179), whereas β-hCG levels declined significantly ( p < 0.0001). Receiver operating characteristic (ROC) curve analysis demonstrated initial diagnostic potential for GDF-15, yielding an area under the curve (AUC) of 0.88. Conclusions Maternal serum GDF-15 demonstrates effective potential as a promising candidate biomarker for identifying threatened miscarriage. Its levels did not show a significant short-term change following standard progesterone administration, suggesting it potentially reflects underlying placental dysfunction rather than temporary hormonal fluctuations. GDF-15 holds potential as an early, stable biomarker for risk stratification in threatened miscarriage cases.