# Fibrinogen to Albumin Ratio, Lactate Dehydrogenase to Albumin Ratio and Uric Acid to Albumin Ratio in Preeclampsia

## TL;DR

This study explores blood markers to distinguish between mild and severe preeclampsia, finding that UAR and LAR are more effective than FAR.

## Contribution

This is the first study to evaluate LAR as a biomarker for severe preeclampsia.

## Key findings

- FAR was significantly higher in preeclampsia patients compared to controls but not between mild and severe cases.
- UAR and LAR showed significant differences between preeclampsia patients with and without severe features and controls.
- LAR had higher sensitivity and specificity than UAR in distinguishing severe preeclampsia cases.

## Abstract

Background/Objectives: Preeclampsia can be divided into two groups (with and without severe features) based symptom severity. We aimed to distinguish these two entities with the aid of fibrinogen to albumin ratio (FAR), uric to acid albumin ratio (UAR) and LDH to albumin ratio (LAR). Methods: This retrospective study was conducted in Istanbul Basaksehir Cam and Sakura City Hospital between 2020 and 2023. Seventy-three patients with preeclampsia were included in this study which were categorized into two groups according to disease severity: 40 patients with preeclampsia without severe features and 33 patients with severe features. Additionally, 30 healthy pregnant women were included as a control group. Neutrophil–lymphocyte ratio (NLR), monocyte–lymphocyte ratio (MLR), platelet–lymphocyte ratio (PLR), mean platelet volume (MPV), red cell distribution width (RDW), mean platelet volume (MPV), Uric acid, LDH, AST, ALT, fibrinogen, albumin, FAR, UAR and LAR were compared among the groups. Results: FAR was significantly higher in preeclampsia patients with and without severe features compared to control group (Odds ratio 8.32 for ≥0.139 vs. <0.139, p < 0.001). There was no significant difference in FAR levels between preeclampsia patients according to disease severity. UAR and LAR were significantly different between preeclampsia patients with and without severe features and the control group (p < 0.001). Receiver operating characteristics (ROC) curves for UAR showed that a cut-off value of 1.727 had a sensitivity of 73% and a specificity of 68% in discriminating between preeclampsia with and without severe features (Odds ratio 5.53 for ≥1.727 vs. <1.727). ROC curves for LAR showed that a cut-off value of 79.09 had a sensitivity of 85% and a specificity of 73% in discriminating between preeclampsia with and without severe features (Odds ratio 14.76 for ≥79.09 vs. <79.09). Conclusions: UAR and LAR appear to be better markers than FAR for identifying preeclamptic patients who require delivery due to severe features. They are easily accessible and promising biomarkers, and to our knowledge, this is the first study to evaluate LAR in this context. Further studies are needed to validate their diagnostic accuracy and compare their performance with established biomarkers.