Diagnostic Value of the Third-Trimester Fibrinogen-to-Albumin Ratio for Predicting PE and Small-for-Gestational-Age Neonates: A Retrospective Study

Objective: To evaluate whether the fibrinogen-to-albumin ratio (FAR), measured mainly in the third trimester, is associated with and can predict preeclampsia (PE) and small-for-gestational-age (SGA) neonates in pregnant women. Methods:In this retrospective study involving 30 patients (PE group) and 330 controls, the FAR was calculated, and its role in predicting PE and SGA was investigated.Additionally, gestational age at delivery, birth weight, percentile values, hemogram parameters, and biochemical variables were compared between the groups.Results: FAR did not demonstrate sufficient diagnostic power to predict PE [receiver operating characteristic, area under the curve (AUC)= 0.527]; however, decreased serum albumin level was significantly associated with increased risk of PE [odds ratio (OR)= 0.768].Albumin was identified as an independent predictor of PE (multivariate OR= 0.768, 95% confidence interval: 0.662-0.891,p < 0.001).Furthermore, no significant association was found between FAR and birth weight, SGA, or birth weight percentile values.Conclusion: FAR alone does not possess sufficient diagnostic power (AUC= 0.527).Albumin emerged as a consistent predictor across all analyses (univariate OR= 0.768; multivariate OR= 0.768).Urea and alanine aminotransferase were also identified as independent predictors in the multivariate model.No significant association was detected between FAR and birth weight or SGA.