Relationship Between Fibrinogen-to-Albumin Ratio and Pre-Eclampsia: A Retrospective Cohort Study.
Academic Article
Overview
abstract
BACKGROUND: Preeclampsia is a leading cause of maternal and fetal morbidity and mortality, but cost-effective, accessible biomarkers remain limited. The fibrinogen-to-albumin ratio (FAR) is a promising inflammatory marker but has not been thoroughly evaluated in diverse populations for its association with preeclampsia. METHODS: We conducted a retrospective cohort analysis of 3,249 patients who delivered at a large academic center in New York City between March 2018 and February 2024. Patients were categorized as control (N = 2,216), preeclampsia without severe features (PE; N = 716), and preeclampsia with severe features (sPE; N = 317). Demographic, clinical, and laboratory characteristics were analyzed. Univariate and multivariate analysis with stepwise AIC selection assessed associations between FAR and preeclampsia. Discriminatory performance was evaluated using area under the curve. RESULTS: FAR was significantly higher in PE groups compared to controls (P < 0.001). Univariate analysis showed significant associations between FAR and any PE (PE + sPE) (OR 25.2, 95 % CI: 6.63-95.82, P < 0.001) and sPE (OR 8.69, 95 % CI: 1.20-62.66, P = 0.032). In multivariate analysis, FAR was independently associated with PE (OR 6.16, 95 % CI: 1.49-25.56, P = 0.012), but not sPE (OR 2.42, 95 % CI: 0.29-18.89, P = 0.924). FAR alone had modest discriminatory power, which improved when combined with other clinical variables. CONCLUSIONS: FAR is independently associated with preeclampsia and may assist clinicians in risk stratification and perioperative planning at labor admission. Prospective, multicenter studies are needed for further validation.
