The Diagnostic Performance of Fibroblast Growth Factor-21 during Early Stage of Missed Miscarriage

Abstract Background: Missed miscarriages (MMs) occur when an embryo without a cardiac pulse or gestational sac is not expelled from the uterus. Fibroblast growth factor-21 (FGF-21), a member of the fibroblast growth factor family, plays an important regulatory role in metabolism, primarily in glucose and lipid metabolism. Objective: The aim of this study is to investigate whether serum levels of FGF-21 are associated with MM in 8–14 weeks of gestation. Materials and Methods: This case–control study consisted of 88 pregnant women; they were divided into two groups: healthy pregnant (HP), composed of 40 women with a normal viable pregnancy at 8–14 weeks of gestation with mean age (29.07 ± 6.96 years); and study group that included 40 women with MM diagnosed by ultrasound at the same gestational age (GA) with mean age (28.27 ± 7.74 years). Demographic criteria and maternal serum FGF-21 levels were recorded for comparison. ELISA technique was used to measure FGF-21 in circulation. Results: This study revealed a statistically significant increase in serum levels of FGF-21 in MMs (142.47 ± 48.036 pg/ml) compared to normal pregnant women (87.9 ± 30.86). The cutoff point was ≥149.97, with high sensitivity (73.2%) and specificity (97.9%). There was no significant correlation between FGF-21 levels and age, GA, body mass index, or gravidity. Conclusion: The MM group’s serum concentrations of FGF-21 were markedly elevated within a time frame of 8–14 weeks compared to the HP group, suggesting its involvement in the development of MM. Based on the findings, FGF21 demonstrates a remarkable capacity for diagnosing MM.