Maternal Biochemical Profiles in Hypertensive Disorders of Pregnancy: An Observational Study

Background/Objectives: Hypertensive disorders of pregnancy are major contributors to maternal and perinatal morbidity and mortality. This study compared routinely available biochemical and hematological parameters across normotensive pregnancies, pregnancy-induced hypertension (PIH), and preeclampsia (PE), and evaluated their associations with established hypertensive pregnancy status. Methods: This hospital-based observational study included 200 pregnant women at 24–34 weeks of gestation: 59 with PE, 61 with PIH, and 80 normotensive controls. Group differences, logistic regression associations, and discriminatory performance were assessed. An exploratory multivariable analysis compared PE directly with PIH. Results: Significant differences across the three groups were observed for proteinuria (H = 116.58; p < 0.001), serum albumin (H = 62.21; p < 0.001), and lactate dehydrogenase (H = 25.26; p < 0.001). In the primary multivariable model, proteinuria ≥ 0.30 g/24 h (adjusted odds ratio [aOR] = 7.112; 95% CI: 3.228–15.666) and albumin < 35 g/L (aOR = 6.589; 95% CI: 2.705–16.048) were positively associated with combined hypertensive pregnancy status, whereas urea < 1.7 mmol/L showed an inverse association (aOR = 0.137; 95% CI: 0.037–0.509). Proteinuria had the highest discriminatory performance (AUC = 0.840). In the exploratory PE-versus-PIH model, higher albumin was associated with lower odds of PE (aOR per 5 g/L = 0.169; 95% CI: 0.066–0.428), whereas higher urea (aOR per 1 mmol/L = 2.051; 95% CI: 1.308–3.215) and primiparity (aOR = 3.677; 95% CI: 1.338–10.101) were associated with higher odds. Conclusions: Proteinuria and hypoalbuminemia were strongly associated with established hypertensive pregnancy status. Exploratory PIH–PE comparisons additionally identified associations involving albumin, urea, and primiparity. These concurrent findings should not be interpreted as prospective predictors.