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OBJECTIVE: The objective of the study was to evaluate maternal serum pro-early placenta insulin like (proEPIL) levels during normal and pathologic pregnancy by using a newly developed enzyme-linked immunosorbent assay, based on a monoclonal antibody designated EPIL15 and directed to the pro-EPIL C-chain 98-108 region. STUDY DESIGN: In a group of healthy pregnant women (n = 22), proEPIL peptide serum levels were measured longitudinally throughout gestation (8-12, 20-24, and 30-34 weeks). Serum proEPIL levels were measured in women with preterm labor (n = 24), intrauterine growth restriction (n = 27), and preeclampsia (n = 12). RESULTS: In healthy pregnant women, a significant rise of serum pro-EPIL levels (mean +/- SEM) was observed during the third trimester of gestation (30.97 +/- 2.978 ng/mL; P < .01), with the highest serum levels at 30-34 weeks' gestation (P < .001). Serum proEPIL levels were found elevated in women with intrauterine growth restriction (107.4 +/- 12.99 ng/mL), preeclampsia (104.8 +/- 36.20 ng/mL), or preterm labor (183.8 +/- 36.42 ng/mL) in comparison with levels observed in healthy pregnant women (P < .001). CONCLUSION: These results showed that proEPIL secretion increases in the last trimester during normal pregnancy and is highly secreted in women with pathologic conditions. [ABSTRACT FROM AUTHOR]