Utility of the fibrinogen–albumin ratio and CRP–albumin ratio in previable preterm early membrane rupture

The aim of this study was to analyze the inflammatory markers, including C-reactive protein to albumin (ALB) ratios (CAR), and fibrinogen to ALB ratios (FAR) of pregnant women who visited the obstetrics clinic of our hospital and were diagnosed with previable preterm prelabor rupture of membranes (PPROM), defined as delivery between 200/7 and 256/7 weeks at the border of fetal viability, and to compare the scores with those of the healthy control group. We also aimed to determine the utility of these laboratory scores in women who aborted or continued their pregnancy and live births. Patients aged 18 to 45 diagnosed with previable PPROM between 16 and 22 weeks with singleton live pregnancies were included. Patients with uterine or fetal anomalies, multiple pregnancies, or history of chronic inflammatory disease were excluded. A total of 79 pregnant women were divided into 2 groups: healthy pregnant controls (control, n = 30) and patients diagnosed with previable PPROM (n = 49). 35/49 (71.4%) preferred expectant management. Of these 35 patients 14/35 (40%) had live birth and 21/35 (60%) had abortions. C-reactive protein (23 mg/dl), CAR (0.84), and FAR values were statistically significantly higher, whereas ALB levels (34.2 g/L) were lower in previable PPROM patients than in controls (P < .001). More importantly, our findings indicated that the FAR at admission (1.4, P < .001) was positively correlated with abortion in previable PPROM among the patients during expectant management. Receiver operating characteristic analysis revealed that the area under the curve for FAR was 0.840 (P < .001; sensitivity, 76.2%; specificity, 85.7%), and FAR presented the highest predictive value with a 1.18 cut point for abortion in previable PPROM. While the CAR value was significantly higher in patients with PPROM in the patient and control groups, the FAR value was significantly higher in patients who aborted in the PPROM group than in those with live pregnancies. Routine markers that are readily derived in daily clinical practice, such as the FAR, may have clinical significance in evaluating predicting prognosis in previable PPROM.