Key result
Small-for-gestational-age neonates and infants of gestational diabetic mothers have elevated serum ELABELA versus healthy controls.
Why the study?
Infants of mothers with GDM and SGA infants experience intrauterine cardiac remodeling, and ELABELA is key to cardiovascular development, prompting investigation into their serum ELABELA levels and cardiac findings.
Are serum ELABELA concentrations elevated in infants of gestational diabetic mothers and small-for-gestational-age neonates compared to healthy controls, and do they correlate with echocardiographic parameters?
Observational (n=78)
Blinded assessors
No
Are serum ELABELA concentrations elevated in infants of gestational diabetic mothers and small-for-gestational-age neonates compared to healthy controls, and do they correlate with echocardiographic parameters?
Absolute Event Rate: 226.2% vs 175.4%
p-value: p=0.001
Serum ELABELA concentrations are elevated in GDM-exposed and SGA neonates compared to healthy controls, but do not correlate with early echocardiographic structural changes.
Elevated ELABELA in SGA and GDM neonates is hypothesis-generating; leaves open any biomarker role pending prospective validation.
Background Infants born to mothers with Gestational Diabetes Mellitus (GDM) and those born Small for Gestational Age (SGA) undergo cardiac remodeling as a result of intrauterine metabolic and hemodynamic influences. ELABELA plays a key role in embryonic vasculogenesis and cardiovascular development. The study aimed to investigate the relationship between serum ELABELA concentrations and cardiac findings in GDM-exposed and SGA neonates. Methods In this prospective study, serum ELABELA levels were measured in 78 neonates divided into three groups: infants of GDM mothers ( n = 24), SGA infants ( n = 24), and healthy controls ( n = 30). Echocardiographic evaluation was performed between postnatal days 3 and 5. Demographic, laboratory, and echocardiographic data were compared across groups. Receiver Operating Characteristic (ROC) analysis was used to evaluate the diagnostic performance of ELABELA. Results Aortic annulus measurements were significantly lower in the SGA group compared with the GDM and control groups ( p = 0.001). ELABELA showed good discriminatory ability for distinguishing SGA infants from controls (AUC: 0.816, p < 0.001), with an optimal cut-off value of 202.6 units (sensitivity: 73.3%, specificity: 83.3%). For GDM infants, ELABELA also showed discriminatory ability (AUC: 0.721, p = 0.009). No significant association was observed between ELABELA levels and the assessed echocardiographic parameters. Conclusion Serum ELABELA levels were higher in GDM-exposed and SGA neonates than in healthy controls. The biological significance of this elevation and its relationship with intrauterine conditions remain uncertain. Although ELABELA demonstrated discriminatory ability between high-risk neonatal groups and controls, no significant association with echocardiographic abnormalities was observed. Further longitudinal studies are needed to determine its clinical and prognostic significance.
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Yılmaz et al. (2026) conducted an observational in Gestational Diabetes Mellitus and Small for Gestational Age (n=78). Gestational diabetes mellitus or small-for-gestational-age status vs. Healthy controls was evaluated on Serum ELABELA concentrations (p=0.001). Serum ELABELA concentrations were significantly elevated in small-for-gestational-age neonates (median 226.2) and infants of gestational diabetic mothers (193.8) versus healthy controls (175.4).
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