Unraveling preeclampsia: Is the fibrinogen-to-albumin ratio the key to early risk assessment?
International Journal of Gynecology and Obstetrics, cilt.172, sa.3, ss.1553-1560, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 172 Sayı: 3
- Basım Tarihi: 2026
- Doi Numarası: 10.1002/ijgo.70510
- Dergi Adı: International Journal of Gynecology and Obstetrics
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, Gender Studies Database, MEDLINE, Public Affairs Index, Academic Search Ultimate (EBSCO)
- Sayfa Sayıları: ss.1553-1560
- Anahtar Kelimeler: aspirin prophylaxis, early prediction, fibrinogen/albumin ratio, first trimester, maternal outcomes, neonatal outcomes, preeclampsia, pregnancy biomarkers, risk stratification
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: Preeclampsia is a significant cause of maternal and neonatal morbidity and mortality. Early prediction is crucial for improving perinatal outcomes and enabling timely prophylactic interventions. This study aims to evaluate the predictive value of the fibrinogen-to-albumin ratio (FAR) in the first trimester for preeclampsia, its severity, and associated adverse pregnancy outcomes. Methods: This retrospective cohort study was conducted at the Perinatology Clinic of Bilkent City Hospital between January 2022 and April 2022. The records of 2116 pregnant women who underwent first-trimester combined screening at 12 weeks of gestation were reviewed, and after applying exclusion criteria, 112 women diagnosed with preeclampsia were identified. An equal number of normotensive pregnant women were randomly selected as controls from the same hospital database within the same period. Maternal blood samples were analyzed for fibrinogen and albumin levels, and the FAR was calculated. Clinical and neonatal outcomes were recorded. Statistical analyses included independent t-tests, χ2-tests, receiver operating characteristic (ROC) curve analysis, and logistic regression modeling to evaluate the predictive value of FAR for preeclampsia. Results: Fibrinogen levels were significantly higher in the preeclampsia group (4.64 ± 1.21 g/L) compared to controls (3.94 ± 0.97 g/L, P = 0.032). The FAR was also significantly elevated in the preeclampsia group (0.128 ± 0.04) versus controls (0.106 ± 0.03, P = 0.012). ROC analysis demonstrated good predictive performance for FAR in identifying preeclampsia (area under the curve [AUC]: 0.79; sensitivity: 86.1%, specificity: 70.6%) and severe preeclampsia (AUC: 0.83; sensitivity: 88.6%, specificity: 74.5%). Higher FAR was significantly associated with an increased risk of placental abruption (odds ratio [OR]: 2.1, P = 0.018), neonatal respiratory distress syndrome (OR: 2.25, P = 0.017), and neonatal intensive care unit admission (OR: 2.19, P = 0.018). Conclusion: The FAR is a promising biomarker for the early prediction of preeclampsia, its severity, and adverse perinatal outcomes. Given its accessibility, affordability, and strong predictive value, FAR could be integrated into first-trimester screening protocols alongside existing markers to improve early risk stratification. Further multi-center validation studies are recommended to optimize predictive models for clinical use.