A groundbreaking blood test may enable doctors to identify laboring women at risk for preeclampsia—a leading cause of maternal mortality—according to research presented at the ANESTHESIOLOGY® 2024 annual meeting.
The Centers for Disease Control and Prevention (CDC) reports that between 5% and 10% of pregnant women develop preeclampsia, characterized by sudden high blood pressure and protein in the urine. Black women face a 60% higher likelihood of developing this condition compared to white women, along with increased risks of severe outcomes, including kidney damage. Although preeclampsia can arise as early as the 20th week of pregnancy, this study specifically targeted women admitted to the hospital during labor.
Researchers discovered that by calculating the ratio of two blood proteins—fibrinogen and albumin—doctors can effectively predict a woman’s risk of developing preeclampsia. Fibrinogen, which plays a role in blood clotting and inflammation, may be elevated, while albumin, which maintains fluid balance and transports vital substances in the body, may be reduced. Both protein levels can be disrupted by preeclampsia.
The study highlighted that the fibrinogen-to-albumin ratio (FAR) lacks a universally accepted normal range but typically spans from 0.05 to 1 or higher. Elevated FAR values correlate with increased inflammation and serious health issues. This trend has been observed in other inflammatory conditions, such as rheumatoid arthritis and cardiovascular diseases.
In the analysis of 2,629 women who gave birth between 2018 and 2024, researchers categorized participants into three groups: 1,819 without preeclampsia, 584 with mild preeclampsia, and 226 with severe preeclampsia. Findings revealed that women with a higher FAR were more likely to develop preeclampsia. Specifically, the likelihood of developing any degree of preeclampsia was 24% for those with a FAR of at least 0.1, increasing to over 41% for those with a FAR above 0.3.
For women identified as high-risk based on the FAR and other clinical indicators—such as age over 35, chronic high blood pressure, or obesity—obstetricians and anesthesiologists can implement additional precautions. These may include more frequent monitoring of blood pressure and fluid levels or early administration of an epidural for pain management if severe symptoms are predicted.
While the FAR has been linked to other inflammatory conditions, this study marks a significant advancement in its application to preeclampsia, particularly within a large, racially diverse cohort. “Our study demonstrates that FAR can serve as a valuable predictive tool for anesthesiologists and obstetricians assessing the risk of preeclampsia in laboring women,” said Lucy Shang, B.A., lead author of the study and medical student at the Icahn School of Medicine at Mount Sinai, New York.
Shang emphasized the importance of assessing the FAR for all pregnant women, particularly those at higher risk, including Black women and those with hypertension or obesity. “Further research is needed to define concerning FAR thresholds and to incorporate this metric into routine prenatal care for early identification of preeclampsia,” she noted.
Date: 20th,Oct,2024
Source: American Society of Anesthesiologists
