The Predictive Value of First Trimester Fibrinogen-Albumin Ratio for Late Onset Fetal Growth Restriction

Yıl 2025, Cilt: 47 Sayı: 2, 316 - 323, 27.02.2025

Osman Onur Özkavak , Dilek Sahin

Öz

Fetal growth restriction (FGR) is a common cause of adverse pregnancy outcomes, with two main categories: early and late onset.The standard cut-off gestational age is 32 weeks.There's no accepted screening method for early pregnancy prediction. Maternal inflammation is a key factor in FGR development. In the context of inflammation, fibrinogen levels increase and albumin levels decrease, resulting in an elevated fibrinogen albumin ratio (FAR). FAR has been shown to be a valuable prognostic marker for various inflammation-related diseases. This retrospective study aimed to investigate the value of first trimester FAR in predicting the development of late-onset FGR. The study found that first trimester CRP, fibrinogen, and FAR values were statistically significantly higher in the FGR group (p<0.001 for all). ROC curve analyses demonstrated that both CRP and FAR exhibited significant predictive capabilities for the development of late FGR. However, the performance of the conventional inflammatory marker “CRP” (sensitivity:61%, specificity:60%) in predicting FGR was found to be inferior to that of FAR (sensitivity:73%, specificity:71%). Also, the FGR group demonstrated significantly elevated rates of adverse neonatal outcomes and neonatal intensive care unit hospitalization. The prediction of FGR risk in early pregnancy is crucial for the implementation of appropriate pregnancy follow-ups and the administration of necessary preventive strategies.This study underscores the potential value of FAR as a prognostic instrument to estimate the probability of late FGR.

Anahtar Kelimeler

Fetal growth restriction, inflammation, fibrinogen-albumin ratio

İlk Trimester Fibrinojen-Albumin Oranının Geç Fetal Gelişim Kısıtlılığı Öngörüsündeki Değeri

Öz

Fetal büyüme kısıtlılığı (FGR), erken ve geç başlangıçlı olmak üzere iki ana gruba ayrılır ve olumsuz perinatal sonuçların yaygın bir nedenidir. İki grup arasında ayrım 32. gebelik haftasına göre yapılmaktadır. Erken gebelik döneminde FGR öngörüsü için yaygın olarak kabul gören bir tarama yöntemi yoktur. Maternal inflamasyon, FGR gelişiminde önemli bir faktördür. İnflamasyon varlığında, fibrinojen seviyeleri artar ve albümin seviyeleri azalır, bu da fibrinojen albümin oranının (FAR) yükselmesine neden olur. FAR'ın inflamasyonla ilişkili çeşitli hastalıklar için değerli bir prognostik belirteç olduğu gösterilmiştir. Bu retrospektif çalışma, geç başlangıçlı FGR gelişimini öngörmede ilk trimester FAR'ın değerini araştırmayı amaçlamıştır. Çalışmada ilk trimester CRP, fibrinojen ve FAR değerlerinin FGR grubunda istatistiksel olarak anlamlı derecede yüksek olduğu bulunmuştur (tümü için p<0,001). ROC eğrisi analizleri, hem CRP hem de FAR'ın geç FGR gelişimi için istatistiksel olarak anlamlı şekilde prediktif performans sergilediğini göstermiştir. Bununla birlikte, konvansiyonel bir inflamatuar belirteç olan “CRP ”nin FGR'yi öngörme performansı (duyarlılık:%61, özgüllük:%60) FAR değerinden (duyarlılık:%73, özgüllük:%71) daha düşük bulunmuştur. Ayrıca, FGR grubunda olumsuz yenidoğan sonuçları ve yenidoğan yoğun bakım ünitesine yatış oranları anlamlı şekilde yüksek bulunmuştur. Erken gebelikte FGR riskinin öngörülmesi, uygun gebelik takiplerinin planlanması ve gerekli önleyici stratejilerin uygulanması için çok önemlidir. Bu çalışma ile FAR değerinin geç FGR gelişimini öngörmek için potansiyel bir prognostik belirteç olduğu gösterilmiştir..

Anahtar Kelimeler

Fetal büyüme kısıtlılığı, inflamasyon, fibrinojen-albümin oranı.

Kaynakça

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