A routine blood test assessing the fibrinogen-to-albumin ratio (FAR) can effectively identify women in labor who are at risk for developing preeclampsia, a leading cause of maternal death due to high blood pressure. The study, presented at the American Society of Anesthesiologists’ annual meeting, highlights the potential of FAR as a predictive tool for this pregnancy-related complication.
FAR as a Predictive Tool
Researchers found that by measuring fibrinogen and albumin levels upon a woman's admission to the hospital for delivery, doctors could predict her risk of preeclampsia. Lucy Shang, a medical student at the Icahn School of Medicine at Mount Sinai, noted that women with an elevated FAR could have up to a 41% increased risk of preeclampsia.
Between 5% and 10% of pregnant women develop preeclampsia, which can lead to premature birth, bleeding problems, kidney and liver damage, seizures, or stroke. In severe cases, it poses a threat to both the mother and child.
Understanding Fibrinogen and Albumin
Fibrinogen, a protein involved in blood clotting and inflammation, and albumin, which maintains fluid balance and transports hormones, vitamins, and enzymes, are both affected by preeclampsia. The condition can cause fibrinogen levels to rise while albumin levels fall, leading to a higher FAR, often associated with increased inflammation, infection, or other serious health concerns.
Study Details and Findings
The study analyzed data from over 2,600 women who gave birth between 2018 and 2024, including 584 with mild preeclampsia and 226 with severe preeclampsia. Severe preeclampsia was defined as blood pressure of 160/110 or higher, along with signs of organ damage such as severe headaches, elevated liver enzymes, visual disturbances, low platelet count, or kidney impairment.
While there is no universally established normal FAR value, which can range from 0.05 to 1 or higher, the study found that women with a FAR of at least 0.1 had a 24% increased risk of preeclampsia. Those with a FAR above 0.3 had an increased risk of more than 41%.
Clinical Implications
Identifying women at risk allows doctors to take extra precautions, such as more frequent blood pressure checks, maintaining stable fluid levels, and administering early epidurals for pain management. Shang emphasized the importance of assessing FAR in all pregnant women, particularly those at higher risk, including Black women, women with high blood pressure, and obese women. Black women are 60% more likely to develop preeclampsia than white women and face a higher risk of severe outcomes.
Future Research
Shang called for additional research to determine the precise FAR range that should be considered concerning and to explore its potential integration into routine prenatal care as a predictive tool for early preeclampsia identification. The study's findings are considered preliminary until published in a peer-reviewed journal.
