#2541 Severity of preeclampsia and fetal complications—potential association with serum albumin levels?

Abstract Background and Aims Preeclampsia (PE) affects 5-8% of pregnancies worldwide. Recent studies have suggested that serum albumin and proteinuria are related to the severity of PE and its complications. The Canadian Society of Obstetrics and Gynecology suggested that a serum albumin level of 2 g/dl or less may represent one of the criteria of severity. The aim of the study was to assess the relevance of serum albumin level in the severity of preeclampsia, and its potential association with maternal and fetal complications. Method A descriptive and prospective study was used for analyzing the relevance of serum albumin level in the severity of preeclampsia, and its potential association with maternal and fetal complications, at a level less than 2 g/dL. Results The study group included 59 pregnant women with PE and depending on severity of preeclampsia were established 2 groups: 23 women with mild PE and 36 women with severe PE. Depending on the gestational age at onset of PE, the study groups were divided into 2 groups: early onset (<34 weeks) and late onset (>34 weeks). The risk of finding severe PE in pregnant women with early onset is 5.625 times higher than the risk of finding severe PE in pregnant women with late onset (OR = 5.625, 95% CI for OR = 1.794–17.633). Albumin levels were significantly different between the group with severe PE versus mild PE (2.44 ± 0.36, respectively 1.82 ± 0.50; t = −5.507, df = 56.381, P < 0.001). The Youden index was 0.6280, establishing a level of 2.3 g/dl which represents the threshold between the severe PE and the mild PE (sensitivity 88.89%, specificity 73.9%) We observed a strong association between albumin <2 g/dL and severe proteinuria. The risk of encountering the impairment of renal function, liver function and severe proteinuria/24 h in pregnant women with serum albumin >2 g/dL is considered equal to the risk of encountering impairment of renal function, liver function and severe proteinuria in patients with serum albumin <2 g/dL (Table 1).The risk of fetal complications, prematurity and low birth weight in pregnant women with serum albumin >2 (g/dL) is considered equal to the risk of fetal complications, prematurity and low birth weight in patients with serum albumin <2 (g/dL) (Table 2). There was no association of serum albumin level with gestational age, dysfunction of renal/hepatic function and proteinuria/24 h. (P > α = 0.05) or fetal complications, prematurity, and low birth weight of the new-born (P > α = 0.05) Conclusion Serum albumin was increased in the group of pregnant women with severe PE compared to mild PE. Serum albumin levels less than 2 g/dL are not mandatory to be included in the PE severity criteria, more studies are required. Prematurity and low birth weight are fetal complications frequently associated with PE, but could not be correlated with low value of serum albumin in pregnant women with PE.

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