Photo Credit: Selvanegra

A blood test measuring the fibrinogen-to-albumin ratio may help predict preeclampsia in laboring women, aiding early intervention and care strategies.

A routine blood test could help physicians identify laboring women who are at risk for preeclampsia and take precautions to prevent it, according to a press release by the American Society of Anesthesiologists.

While preeclampsia can develop as early as the 20th week of pregnancy, Lucy Shang and colleagues focused on identifying women who were at risk for this condition when they were admitted to the hospital in labor.

Physicians can predict a woman’s risk for developing preeclampsia by calculating the ratio of two blood proteins—fibrinogen and albumin—measured in routine blood tests when women in labor are admitted to the hospital. The fibrinogen-to-albumin ratio (FAR) has no universally established normal value, but it can range from 0.05 to 1 or higher.

Researchers analyzed the records of 2,629 women who gave birth between 2018 and 2019. Of these patients:

• 1,819 did not have preeclampsia;
• 584 had preeclampsia with mild features or symptoms (including BP of 140/90 mm Hg or higher, but no significant signs of organ damage); and
• 226 had preeclampsia with severe features or symptoms (including BP of 160/110 mm Hg or higher and signs of organ damage, including severe headaches, high liver enzymes, visual disturbances, or low platelet count).

The researchers determined that patients with a higher FAR were more likely to develop preeclampsia than patients without the condition. The predicted likelihood of developing any degree of preeclampsia was 24% for patients with a FAR of at least 0.1 on hospital admission, and it rose to more than 41% when that value was above 0.3.

“While FAR has been associated with other inflammatory conditions, its specific application to preeclampsia and preeclampsia with severe symptoms has not been reported in a group this large and racially diverse,” said Shang, a medical student at the Icahn School of Medicine at Mount Sinai, New York, in the press release. “Our study shows that FAR can be a predictive tool that gives anesthesiologists and obstetricians a new method for assessing a laboring mom’s risk of developing preeclampsia when they are admitted to the hospital.”

Although this ratio should be assessed for all pregnant women, calculating the FAR is crucial for women who are at higher risk for preeclampsia, such as Black women, and those with high BP and obesity, she noted.

Additional research is warranted to identify the exact range of the FAR that would be considered concerning.