Abstract
Objective: To demonstrate whether the albumin-to-globulin ratio (AGR) index is a useful marker during pregnancy in order to identify severe preeclampsia and to determine its predictive power.
Methods: A cross-sectional, analytical, and observational study was conducted in a population of Mexican pregnant women with more than 20 weeks of gestation who were included in an outpatient survey, as well as those patients who were admitted to the Women’s Hospital of Culiacan, Mexico, from January 2021 to January 2023. Patients with malnutrition or with body mass index (BMI)<19 kg/m2, patients with chronic renal failure, drug addiction, intestinal malabsorption syndromes, autoimmune diseases, collagen diseases, or myeloproliferative disorders were excluded. Urine samples were collected over 24 hours to measure proteinuria, and blood samples were collected to measure total blood proteins, albumin, globulin, magnesium, calcium, lactate dehydrogenase, uric acid, C-reactive protein, complete blood count, urea, urea nitrogen, and creatinine. The analysis was performed using Stata SE 13 (College Station, Texas 77845, USA).
Results: There were 80 (36.65%) cases of hypoalbuminemia, of which 7 (21.88%) occurred in healthy women, 26 (60.47%) in severe preeclampsia, and the overall frequency of AGR<1.2 was 61 (27.98%), with the highest number of cases in severe preeclampsia. There were 142 (63.68%) patients with other maternal complications and 8 (3.67%) fetal complications. The frequency of AGR<1.2 was 6 (18.75%) in healthy women and 19 (45.24%) in severe preeclampsia (p=0.0178). The AGR<1.2 was significantly associated with severe preeclampsia (OR=3.57, p=0.0201).
Conclusion: The presence of an AGR lower than 1.2 is associated with severe preeclampsia with greater specificity than albumin alone.
Joel Murillo-Llanes, Francisco Javier Castro-Apodaca, Adrian Canizalez-Roman, Ignacio Osuna-Ramirez, Mitzli Paola Hurtado-Rivera, Luis Diego Barragán-Loera, Nancy Godoy Rodríguez, Francisco Javier Hernández-Mora, Alberto Ballesteros-Manzo, Fernando González-Ibarra
