Fibrinogen-to-Albumin, Platelet-to-Albumin, and Creatinine-to-Albumin Ratios in the Assessment of Preeclampsia Severity: A Retrospective Case–Control Study
- 1Perinatology Unit, Department of Obstetrics and Gynecology, Ankara Bilkent City Hospital, University of Health Sciences, Ankara 06800, Turkey
- 2Department of Obstetrics and Gynecology, Diyarbakir Gazi Yasargil Research and Training Hospital, Diyarbakir 21070, Turkey
- 3Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Diyarbakir Gazi Yasargil Research and Training Hospital, Diyarbakir 21070, Turkey
Abstract
Background: Preeclampsia (PE) is a multisystem pregnancy disorder associated with endothelial dysfunction, inflammation, and coagulation abnormalities. This study evaluated the fibrinogen-to-albumin ratio (FAR), platelet-to-albumin ratio (PAR), and creatinine-to-albumin ratio (CrAR) in relation to preeclampsia severity. Methods: This single-center retrospective case–control study included 205 pregnant women: 104 healthy controls, 70 patients with non-severe PE, and 31 with severe PE. Clinical, obstetric, neonatal, and laboratory data were reviewed. Group comparisons, receiver operating characteristic (ROC) analysis, and logistic regression adjusted for maternal age, body mass index, and gestational age at sampling were performed. Results: Fibrinogen and FAR were significantly higher in severe than in non-severe PE. Fibrinogen showed an area under the curve of 0.685, with 67.7% sensitivity and 58.6% specificity at a cut-off of 5.05 g/L. FAR showed an area under the curve of 0.657, with 67.7% sensitivity and 64.3% specificity at a cut-off of 0.143. Both fibrinogen and FAR remained independently associated with severe PE after adjustment for maternal age, body mass index, and gestational age at sampling. FAR did not demonstrate superior discriminatory performance compared with fibrinogen alone. PAR did not differ significantly among groups, while CrAR was higher in preeclampsia than in controls but did not discriminate severe disease. Conclusions: Fibrinogen and FAR were associated with severe PE but demonstrated only modest discriminatory performance. FAR did not outperform fibrinogen alone, and its incremental value beyond fibrinogen remains uncertain. Therefore, these findings should be considered exploratory and do not support the use of FAR or fibrinogen as standalone tools for clinical screening, risk stratification, or decision-making. Further prospective, multicenter studies are needed to determine whether these markers provide clinically meaningful value within broader multimodal assessment models.
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BibTeX
@article{kayaalp2026fibrinogentoalbumin,
title = {{Fibrinogen-to-Albumin, Platelet-to-Albumin, and Creatinine-to-Albumin Ratios in the Assessment of Preeclampsia Severity: A Retrospective Case–Control Study}},
author = {Hüseyin Kayaalp and Şeyhmus Tunc and Ebubekir Sıddık Yılmaz and Sedat Akgöl},
journal = {Metabolites},
year = {2026},
month = oct,
doi = {10.3390/metabo16100751},
url = {https://www.mdpi.com/2218-1989/16/10/751},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Fibrinogen-to-Albumin, Platelet-to-Albumin, and Creatinine-to-Albumin Ratios in the Assessment of Preeclampsia Severity: A Retrospective Case–Control Study
AU - Hüseyin Kayaalp
AU - Şeyhmus Tunc
AU - Ebubekir Sıddık Yılmaz
AU - Sedat Akgöl
PY - 2026
DA - 2026/10/01
JO - Metabolites
DO - 10.3390/metabo16100751
UR - https://www.mdpi.com/2218-1989/16/10/751
AB - Background: Preeclampsia (PE) is a multisystem pregnancy disorder associated with endothelial dysfunction, inflammation, and coagulation abnormalities. This study evaluated the fibrinogen-to-albumin ratio (FAR), platelet-to-albumin ratio (PAR), and creatinine-to-albumin ratio (CrAR) in relation to preeclampsia severity. Methods: This single-center retrospective case–control study included 205 pregnant women: 104 healthy controls, 70 patients with non-severe PE, and 31 with severe PE. Clinical, obstetric, neonatal, and laboratory data were reviewed. Group comparisons, receiver operating characteristic (ROC) analysis, and logistic regression adjusted for maternal age, body mass index, and gestational age at sampling were performed. Results: Fibrinogen and FAR were significantly higher in severe than in non-severe PE. Fibrinogen showed an area under the curve of 0.685, with 67.7% sensitivity and 58.6% specificity at a cut-off of 5.05 g/L. FAR showed an area under the curve of 0.657, with 67.7% sensitivity and 64.3% specificity at a cut-off of 0.143. Both fibrinogen and FAR remained independently associated with severe PE after adjustment for maternal age, body mass index, and gestational age at sampling. FAR did not demonstrate superior discriminatory performance compared with fibrinogen alone. PAR did not differ significantly among groups, while CrAR was higher in preeclampsia than in controls but did not discriminate severe disease. Conclusions: Fibrinogen and FAR were associated with severe PE but demonstrated only modest discriminatory performance. FAR did not outperform fibrinogen alone, and its incremental value beyond fibrinogen remains uncertain. Therefore, these findings should be considered exploratory and do not support the use of FAR or fibrinogen as standalone tools for clinical screening, risk stratification, or decision-making. Further prospective, multicenter studies are needed to determine whether these markers provide clinically meaningful value within broader multimodal assessment models.
SN - 2218-1989
ER -