• Posted October 21, 2024

Blood Test Might Spot Women in Labor at Risk for Preeclampsia

A routine blood test can identify women in labor who are at risk for preeclampsia, a high-blood pressure condition that’s a leading cause of maternal death, a new study finds.

Doctors can predict a woman’s risk of developing preeclampsia by looking at her levels of two blood proteins -- fibrinogen and albumin -- when she enters the hospital for delivery, researchers reported Saturday at the American Society of Anesthesiologists’ annual meeting in Philadelphia.

Women with an elevated fibrinogen-to-albumin ratio (FAR) could have as much as a 41% increased risk of preeclampsia, researchers said.

“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,” said lead researcher Lucy Shang, a medical student at the Icahn School of Medicine at Mount Sinai in New York City.

Between 5% and 10% of pregnant women develop preeclampsia, researchers said in background notes.

Complications can include premature birth, bleeding problems, kidney and liver damage, seizures or stroke. In severe cases, the lives of both mother and child are at risk.

Fibrinogen is involved in blood clotting and inflammation, while albumin helps maintain fluid balance and carries hormones, vitamins and enzymes throughout the body, researchers said.

Both proteins can be disrupted by preeclampsia, which can cause fibrinogen levels to rise and albumin levels to fall.

Higher FAR levels often are associated with increased inflammation, infection or serious health concerns, researchers said. The higher the FAR, the greater the concern.

For this study, researchers analyzed records for more than 2,600 women who gave birth between 2018 and 2024, including 584 with mild preeclampsia and 226 with severe preeclampsia.

Severe preeclampsia included blood pressure of 160/110 or higher and signs of organ damage, including severe headaches, elevated liver enzymes, visual disturbances, low platelet count or kidney impairment, researchers said.

There is no universally established normal value for FAR, which can range from 0.05 to 1 or higher, the researchers noted.

In this case, women with a FAR of at least 0.1 had a 24% increased risk of preeclampsia, results show. Those with a FAR of above 0.3 had an increased preeclampsia risk of more than 41%.

Doctors can take extra precautions for women at risk of preeclampsia, researchers noted -- checking blood pressure more frequently, keeping fluid levels stable and placing an early epidural for pain management.

Shang said this ratio should be assessed for all pregnant women, especially those belonging to groups at increased risk for preeclampsia, including Black women, women with high blood pressure and obese women.

Black women are 60% more likely to develop preeclampsia than white women, and are more likely to die or have serious outcomes like kidney damage, researchers said.

“Additional research is needed to determine the exact range of the FAR that would be considered concerning and would be helpful to incorporate into routine prenatal care as a predictive tool for early identification of preeclampsia,” Shang said in a meeting news release.

Because these findings were presented at a medical meeting, they should be considered preliminary until published in a peer-reviewed journal.

More information

Johns Hopkins Medicine has more about preeclampsia.

SOURCE: American Society of Anesthesiologists, news release, Oct. 19, 2024