Master’s Thesis Investigates Biomarkers for the Early Prediction of Missed Miscarriage

On Wednesday, September 8, 2026, a master’s thesis defense was held at the College of Medicine, Al-Nahrain University, Department of Chemistry and Biochemistry, for master’s student Sarah Jameel Mohammed Amin, whose thesis was entitled:

“Assessing the Predictive Value of First Trimester Serum ELABELA
, Angiopoietin-1 and Kisspeptin Levels in Women with Missed
 Miscarriage”

The study aimed to determine the predictive performance of serum biomarkers—ELABELA, Angiopoietin-1, and Kisspeptin—both individually and as a combined model, for the early detection of the risk of missed miscarriage during the first trimester of pregnancy.

The study demonstrated that women with missed miscarriage had significantly lower levels of ELABELA, Angiopoietin-1, Kisspeptin, β-hCG, fibrinogen, and body mass index (BMI) compared with women with viable pregnancies (all p < 0.001), accompanied by increased levels of mean platelet volume (MPV) and plateletcrit (PCT).

Angiopoietin-1 showed a positive correlation with Kisspeptin (r = 0.42, p < 0.001), while Kisspeptin was weakly correlated with β-hCG (r = 0.30, p = 0.02). In contrast, ELABELA was correlated only with fibrinogen (r = 0.34, p = 0.01). Multivariable regression analysis further confirmed that ELABELA was a significant independent protective factor against missed miscarriage (β = −4.151, aOR = 0.016, 95% CI: 0.001–0.287, p = 0.005), highlighting its potential role through a distinct biological pathway.

These findings indicate that the combined diagnostic panel comprising the three biomarkers significantly improves diagnostic performance compared with the individual biomarkers. Therefore, ELABELA, Angiopoietin-1, and Kisspeptin may represent promising biomarkers for the early identification of missed miscarriage, potentially complementing the role of β-hCG in assessing pregnancy viability and continuation.

The discussion committee consisted of:

• Prof. Dr. Ria Suleiman Baban – Chair

• Prof. Dr. Raed Jasim Mohammed – Member

• Prof. Dr. Shaimaa Kadhim Jasim – Member

• Asst. Prof. Dr. Hassan Hussein Taha – Member and Supervisor

• Asst. Prof. Dr. Sarah Abdul-Ridha Al-Rawaf – Member and Supervisor

The thesis was successfully approved with a grade of Excellent.

Media and Government Communication Division
College of Medicine – Al-Nahrain University