Objective To evaluate the predictive value of combined detection of serum endothelial cell-specific molecule-1 (Endocan), serpin peptidase inhibitor clade B member 1 (SerpinB1), and irisin for adverse pregnancy outcomes in patients with pregnancy-induced hypertension (PIH) syndrome.

Methods A total of 150 PIH patients admitted to our hospital from June 2021 to June 2023 were selected as study objects. Based on pregnancy outcomes, the PIH patients were further divided into PIH adverse outcome group (52 cases) and PIH favorable outcome group (98 cases). Additionally, 50 healthy pregnant women were selected as control group. Enzyme-linked immunosorbent assay (ELISA) was used to detect serum Endocan, SerpinB1, and irisin levels at 20-24 weeks of gestation in all subjects.Differences in the levels of these indicators among the three groups were compared. Pearson correlation analysis was employed to clarify the associations between each indicator and adverse pregnancy outcomes.The receiver operating characteristic (ROC) curve was used to analyze the predictive efficacy of single and combined detection of three indicators for adverse pregnancy outcomes in PIH patients.

Results There were no significant differences in general data such as age, gestational age, body mass index, gravidity, parity, and previous abortion history among the three groups (P>0.05). Serum Endocan and SerpinB1 levels in the PIH adverse outcome group were higher than those in the PIH favorable outcome group and the control group, while irisin levels were lower than those in the PIH favorable outcome group and the control group (P < 0.05). Serum Endocan and SerpinB1 levels in the PIH favorable outcome group were higher than those in the control group, and irisin levels were lower than those in the control group (P < 0.05). Pearson correlation analysis showed that serum Endocan and SerpinB1 levels were positively correlated with adverse pregnancy outcomes in PIH patients (r=0.623, 0.587, P < 0.05), while serum irisin level was negatively correlated with adverse pregnancy outcomes in PIH patients (r=-0.542, P < 0.05). ROC curve analysis revealed that the areas under the curve (AUC) for predicting adverse PIH pregnancy outcomes by single detection of Endocan, SerpinB1, and irisin were 0.752 (95%CI, 0.671 to 0.833), 0.725 (95%CI, 0.640 to 0.810), and 0.703 (95%CI, 0.615 to 0.791), respectively. The AUC for combined detection was 0.894 (95%CI, 0.835 to 0.953), which was higher than that of single detection (P < 0.001). The sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of combined detection were superior to those of single detection.

Conclusion Elevated serum Endocan and SerpinB1 levels and decreased irisin level during the second trimester of pregnancy in PIH patients are closely associated with adverse pregnancy outcomes. Combined detection of these three indicators can significantly improve the accuracy in predicting adverse pregnancy outcomes in PIH patients, offering potential reference for clinical early intervention.