Elevated ELABELA levels distinguish neonatal risk groups from controls

Infants whose mothers had gestational diabetes mellitus and infants born small for gestational age had higher serum ELABELA concentrations than healthy controls in a prospective study of 78 neonates. The study also found that ELABELA could statistically distinguish each of these groups from controls, but its concentration was not significantly associated with the echocardiographic parameters assessed. The authors said the biological significance of the elevation and its relationship to intrauterine conditions remain uncertain.

Researchers divided the neonates into three groups: 24 infants of mothers with gestational diabetes mellitus, 24 small-for-gestational-age infants and 30 healthy controls. They measured serum ELABELA levels and compared demographic, laboratory and echocardiographic data across the groups. Echocardiographic evaluation took place between postnatal days 3 and 5.

ELABELA showed its strongest discriminatory performance for distinguishing small-for-gestational-age infants from controls. In receiver operating characteristic analysis, the area under the curve was 0.816 with p less than 0.001. The study reported an optimal cut-off value of 202.6 units, with a sensitivity of 73.3% and a specificity of 83.3%.

For infants of mothers with gestational diabetes mellitus, the area under the curve was 0.721 with p equal to 0.009. These results indicate that ELABELA concentrations differed between the high-risk groups and controls in the analyzed sample, while the reported sensitivity and specificity apply to the small-for-gestational-age versus control comparison. The echocardiographic findings did not show a significant relationship between ELABELA levels and the cardiac measures examined.

Aortic annulus measurements were lower in the small-for-gestational-age group than in both the gestational diabetes and control groups, with a reported p value of 0.001. Despite this difference, the study found no significant association between serum ELABELA concentrations and the assessed echocardiographic parameters. In other words, the ability of ELABELA to separate the study groups statistically was not accompanied by a demonstrated link to the specific cardiac measurements analyzed.

ELABELA has a stated role in embryonic vasculogenesis and cardiovascular development, and the researchers considered how intrauterine metabolic and hemodynamic influences relate to cardiac remodeling in infants exposed to gestational diabetes or born small for gestational age. The sample was limited to 78 neonates divided among three defined groups, and the reported echocardiographic evaluation occurred between days 3 and 5 after birth. The authors called for further longitudinal studies to determine the clinical and prognostic significance of the observed ELABELA elevation.

Until such evidence is available, the ROC results should be understood as group-discrimination findings from this cohort rather than proof that a serum ELABELA measurement can predict cardiac dysfunction or serve as a validated routine clinical test.

Subject of Research: Serum ELABELA concentrations and early echocardiographic findings in neonates exposed to gestational diabetes or born small for gestational age

Article Title: Serum ELABELA concentrations in infants of gestational diabetic mothers and small-for-gestational-age neonates: a prospective study

Article References: Yılmaz, F. H., Büyükeren, M., Can, Ü., Özcan, B., Keçeci, R., Yılmaz, H., & Sarıkaya, S. (2026). Serum ELABELA concentrations in infants of gestational diabetic mothers and small-for-gestational-age neonates: a prospective study. BMC Pediatrics. https://doi.org/10.1186/s12887-026-07611-x

Image Credits: AI Generated

DOI: 10.1186/s12887-026-07611-x

Keywords: ELABELA, gestational diabetes, small for gestational age, neonates, serum biomarker, echocardiography, prospective study, cardiovascular development, Serum, concentrations, infants, gestational