Use of first trimester hemoglobin albumin lymphocyte platelet score and fibrinogen to albumin ratio in the prediction of pre-eclampsia.

Pre-eclampsia (PE) is a severe pregnancy complication associated with increased maternal and fetal morbidity and mortality. In this retrospective study, we aimed to evaluate the predictive value of hemoglobin-albumin-lymphocyte-platelet score and fibrinogen/albumin ratio (FAR) for early diagnosis of PE. Medical records of 252 pregnant women categorized as severe pre-eclampsia, non-severe pre-eclampsia and control groups were analyzed. Biomarker levels including hemoglobin, albumin, lymphocytes, fibrinogen, creatinine, alanine transaminase, aspartate aminotransferase, and platelets were analyzed throughout the first trimester. The results showed that FAR was significantly higher in PE groups compared to controls and correlated with disease severity (area under curve = 0.65, sensitivity = 59%, specificity = 66%, P < .001). Albumin levels were moderately predictive for PE (area under curve = 0.70, sensitivity = 66%, specificity = 71%, P < .001). In contrast, the hemoglobin-albumin-lymphocyte-platelet score did not differ significantly between groups, indicating limited utility for early prediction. Elevated FAR is thought to result from increased fibrinogen levels due to inflammatory and procoagulant mechanisms, whereas decreased albumin levels reflect systemic inflammation associated with PE. Although FAR and albumin show potential as early biomarkers for PE, their diagnostic power alone is moderate. The findings suggest that these parameters may be more effective when combined with established markers such as placental growth factor and soluble fms-like tyrosine kinase-1. The study underlines the need for larger prospective studies to confirm these findings and explore additional biomarkers for improved PE prediction.