Study: Blood Test Can Predict Preeclampsia Risk During Labor

New research says a routine blood test may be able to predict the likelihood of developing preeclampsia for pregnant people in labor.

Researchers with the American Society of Anesthesiologists (ASA) are presenting their findings this weekend at the Anesthesiology 2024 annual meeting. Their research suggests that doctors can predict someone’s risk of developing postpartum preeclampsia by calculating the ratio of two different blood proteins—fibrinogen and albumin—which are measured during routine blood tests when people in labor arrive at the hospital.

According to the ASA, the fibrinogen protein is involved in blood clotting and inflammation, while albumin helps maintain fluid balance and carries hormones, vitamins, and enzymes throughout the body. Levels of both blood proteins can be disrupted with preeclampsia.

Depending on the fibrinogen-to-albumin ratio (FAR) in the blood test results, doctors can determine whether someone is at risk. According to the findings, higher FAR ratios are linked to increased inflammation, infection, or serious health conditions. Researchers believe that the higher the FAR, the greater the concern for preeclampsia.

What is preeclampsia?

Preeclampsia is a serious pregnancy condition that can pose risks to both the birthing parent and baby. According to the Mayo Clinic, it usually develops after the 20th week of pregnancy and is marked by high blood pressure and signs of damage to organs, like the liver or kidneys. If left untreated, it can lead to severe complications like seizures (eclampsia), organ damage, and even death.

For the baby, preeclampsia can restrict blood flow, affecting growth and causing low birth weight or premature birth, per the Mayo Clinic. Early detection and proper management by a healthcare provider are key to minimizing risks.

“Preeclampsia is common, and the incidence is increasing over time,” says Daniel Katz, MD, an anesthesiologist and senior author of the research. “Mortality from preeclampsia is often multifactorial, as it can indirectly contribute to other mortality causes such as postpartum hemorrhage, but can also be a leading cause of mortality itself by causing complications such as stroke.”

According to the Centers for Disease Control and Prevention (CDC), between 5 and 10 percent of pregnant people develop preeclampsia. Black people are also 60 percent more likely to develop preeclampsia than those who are white, and they’re also more likely to die or have serious outcomes such as kidney damage, per the CDC.

Several notable women in Hollywood have even spoken out about their personal experiences with preeclampsia, including Beyonce, Kim Kardashian, and Serena Williams—all in an effort to highlight the maternal health crisis.

“Preeclampsia is common and the incidence is increasing over time.” —Daniel Katz, MD, lead research author

While this research has not been peer-reviewed or published in a medical journal yet (both of which help further establish medical authority), Dr. Katz says there are immediate plans to do so.

“We are currently preparing the manuscript and will be submitting it for publication,” he says. “We are already planning on collaborating and combining data with other institutions to get a larger data set. We also aim to use the data from this study to obtain funding for a prospective observational trial.”

The research and publication process is still ongoing, but Dr. Katz says this routine blood test marker is a step in the right direction for treating preeclampsia before outcomes become severe or fatal. It could also improve the way pregnant people are treated in hospitals during labor.

“If FAR turns out to be a good predictor of preeclampsia and preeclampsia severity, it could be used as part of a scoring system to determine treatment plans for women during labor,” he says. “It could aid in decision-making of having a vaginal or Cesarean delivery, could influence how and when women get epidurals, as well as influencing other decision points.”