Evaluation of Serum Vascular Endothelial Growth Factor (VEGF) and Placental Growth Factor (PlGF) Levels in Unexplained Early Pregnancy Loss: A Case-Control Study

Abstract

Background: Early pregnancy loss, defined as spontaneous termination of pregnancy before 20 weeks of gestation or fetal weight below 500 g, remains a common obstetric complication. While several etiological factors, such as genetic abnormalities and uterine defects, are established, nearly half of the cases remain unexplained, necessitating exploration of underlying biochemical mechanisms. Objective: To evaluate and compare serum levels of vascular endothelial growth factor (VEGF) and placental growth factor (PlGF) in women with early pregnancy loss and healthy pregnant controls of similar gestational age and to assess the association and diagnostic performance of these angiogenic markers. Methods: A hospital-based case-control study was conducted involving 60 pregnant women aged 19-45 years with pregnancies of less than 20 weeks' gestation, including 30 cases of early pregnancy loss and 30 healthy pregnant controls with viable intrauterine pregnancies of comparable gestational age. Participants were recruited from the Department of Obstetrics and Gynecology of HSK Hospital, Bagalkot, and biochemical analysis was performed at Bharatiya Lingayat Development Educational Association (Deemed to be University) (BLDE [DU]), Vijayapura. Serum VEGF and PlGF levels were measured using enzyme-linked immunosorbent assay (ELISA). Statistical analysis was performed using IBM Corp. Released 2014. IBM SPSS Statistics for Windows, Version 20. Armonk, NY: IBM Corp., applying chi-square and independent t-tests, with results expressed as mean ± standard deviation (SD). Receiver operating characteristic (ROC) curve analysis was performed to assess diagnostic performance and derive optimal cut-off values. Results: Serum VEGF and PlGF levels were significantly reduced in cases compared to controls (p < 0.05), indicating impaired angiogenesis in early pregnancy loss. ROC analysis showed adequate diagnostic performance for VEGF and excellent diagnostic performance for PlGF in differentiating cases from controls within this case-control sample. Conclusion: Reduced serum VEGF and PlGF levels are associated with early pregnancy loss and may serve as adjunctive diagnostic biomarkers for identifying altered angiogenic profiles in affected women after validation in larger prospective studies.