Two Blood Proteins May Help Predict Woman's Risk of Developing Preeclampsia: Study Finds

A simple blood test could help doctors identify women in labor who are at risk for preeclampsia -; a leading cause of maternal death -; and take precautions to prevent it, according to research presented at the ANESTHESIOLOGY® 2024 annual meeting.

Researchers have determined doctors can predict a woman's risk of developing preeclampsia by calculating the ratio of two blood proteins -; fibrinogen and albumin -; measured in routine blood tests done when women in labor enter the hospital. Fibrinogen is involved in blood clotting and inflammation, while albumin helps maintain fluid balance and carries hormones, vitamins and enzymes throughout the body. Both can be disrupted with preeclampsia -; fibrinogen may be elevated, albumin may be reduced, or both can occur.

There is no universally established normal value for this fibrinogen-to-albumin ratio (FAR), which can range from 0.05 to 1 or higher. Higher fibrinogen-to-albumin ratio values are often associated with increased inflammation, infection, or serious health conditions, and the higher the fibrinogen-to-albumin ratio, the greater the concern. This trend has been consistently seen when the fibrinogen-to-albumin ratio is used to evaluate other inflammatory conditions, such as rheumatoid arthritis, cardiovascular diseases, and inflammatory bowel disease.

In the study, researchers analyzed the records of 2,629 women who gave birth between 2018 and 2024, 1,819 who did not have preeclampsia, 584 who had preeclampsia with mild features or symptoms, and 226 who had preeclampsia with severe features or symptoms (including blood pressure of 160/110 mm Hg or higher and signs of organ damage, including severe headaches, high liver enzymes, visual disturbances, low platelet count or kidney impairment). The researchers determined those who had a higher fibrinogen-to-albumin ratio were more likely to develop preeclampsia than those with a lower fibrinogen-to-albumin ratio. They found that the predicted likelihood of developing any degree of preeclampsia was 24% for patients with a fibrinogen-to-albumin ratio of at least 0.1 on admission to the hospital, and it rose to more than 41% when that value was above 0.3.

She noted that while this ratio should be assessed for all pregnant women, calculating the fibrinogen-to-albumin ratio is especially important for women who are at higher risk for preeclampsia, such as Black women and those with high blood pressure and obesity. "Additional research is needed to determine the exact range of the fibrinogen-to-albumin ratio that would be considered concerning and would be helpful to incorporate into routine prenatal care as a predictive tool for early identification of preeclampsia," she said.