Combined albumin-adjusted ischemia-modified albumin ratio and uterine artery Doppler for differentiating early-onset preeclampsia from gestational hypertension: a prospective exploratory pilot study.
- 1Department of Obstetrics and Gynecology, SBÜ Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey. [email protected].
- 2Present address: Department of Obstetrics and Gynecology, Esenyurt Necmi Kadıoğlu State Hospital, Esenyurt District, Istanbul, 34517, Turkey. [email protected].
- 3Department of Obstetrics and Gynecology, SBÜ Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey.
Abstract
Background
Distinguishing early-onset preeclampsia (EO-PE) from gestational hypertension (GHT) at initial presentation remains challenging, particularly when classical diagnostic features are absent or evolving. We evaluated whether combining the albumin-adjusted ischemia-modified albumin ratio (IMAR) with uterine artery pulsatility index expressed as multiples of the median (UtA-PI MoM) provides complementary information in this setting.Methods
In this prospective single-center exploratory study, 90 singleton pregnancies (30 EO-PE, 30 GHT, 30 controls) were included. IMAR and UtA-PI MoM were assessed individually and in combination using receiver operating characteristic analysis and logistic regression with bootstrap internal validation.Results
IMAR and UtA-PI MoM were higher in EO-PE than in GHT (p = 0.003 and p < 0.001, respectively), whereas raw IMA did not distinguish the groups. IMAR demonstrated moderate discrimination (AUC 0.727, 95% CI 0.600-0.854), and UtA-PI MoM demonstrated higher performance (AUC 0.844, 95% CI 0.743-0.946). The combined model showed the highest apparent discrimination (AUC 0.898, 95% CI 0.818-0.977; optimism-corrected AUC 0.889), with 83.3% sensitivity and 86.7% specificity at the exploratory operating point.Conclusions
Combining IMAR with UtA-PI MoM may provide complementary information for distinguishing EO-PE from GHT at initial presentation. This exploratory model is not intended to replace established angiogenic biomarkers and requires validation in larger, multicenter studies before clinical application.
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BibTeX
@article{ozbey2026combined,
title = {{Combined albumin-adjusted ischemia-modified albumin ratio and uterine artery Doppler for differentiating early-onset preeclampsia from gestational hypertension: a prospective exploratory pilot study.}},
author = {Serkan Özbey and Handan Turhan Karakuş and Alper Gümüş and Pakizer Banu Kılıçoğlu Dane},
journal = {BMC pregnancy and childbirth},
year = {2026},
month = jul,
doi = {10.1186/s12884-026-09700-2},
url = {https://europepmc.org/article/MED/42897499},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Combined albumin-adjusted ischemia-modified albumin ratio and uterine artery Doppler for differentiating early-onset preeclampsia from gestational hypertension: a prospective exploratory pilot study.
AU - Serkan Özbey
AU - Handan Turhan Karakuş
AU - Alper Gümüş
AU - Pakizer Banu Kılıçoğlu Dane
PY - 2026
DA - 2026/07/01
JO - BMC pregnancy and childbirth
DO - 10.1186/s12884-026-09700-2
UR - https://europepmc.org/article/MED/42897499
AB - Background Distinguishing early-onset preeclampsia (EO-PE) from gestational hypertension (GHT) at initial presentation remains challenging, particularly when classical diagnostic features are absent or evolving. We evaluated whether combining the albumin-adjusted ischemia-modified albumin ratio (IMAR) with uterine artery pulsatility index expressed as multiples of the median (UtA-PI MoM) provides complementary information in this setting.Methods In this prospective single-center exploratory study, 90 singleton pregnancies (30 EO-PE, 30 GHT, 30 controls) were included. IMAR and UtA-PI MoM were assessed individually and in combination using receiver operating characteristic analysis and logistic regression with bootstrap internal validation.Results IMAR and UtA-PI MoM were higher in EO-PE than in GHT (p = 0.003 and p < 0.001, respectively), whereas raw IMA did not distinguish the groups. IMAR demonstrated moderate discrimination (AUC 0.727, 95% CI 0.600-0.854), and UtA-PI MoM demonstrated higher performance (AUC 0.844, 95% CI 0.743-0.946). The combined model showed the highest apparent discrimination (AUC 0.898, 95% CI 0.818-0.977; optimism-corrected AUC 0.889), with 83.3% sensitivity and 86.7% specificity at the exploratory operating point.Conclusions Combining IMAR with UtA-PI MoM may provide complementary information for distinguishing EO-PE from GHT at initial presentation. This exploratory model is not intended to replace established angiogenic biomarkers and requires validation in larger, multicenter studies before clinical application.
SN - 1471-2393
ER -