Hypoalbuminemia as a severity predictor of preeclampsia in a multicenter study from Indonesia

Hypertensive disorders of pregnancy, affecting 5-10% of pregnancies, pose significant risks to maternal and fetal health. Pregnant women with preeclampsia and proteinuria experience a gradual decrease in serum albumin due to increased protein requirements, urinary protein loss, and endothelial damage. This study aimed to investigate the correlation between hypoalbuminemia and the severity of preeclampsia. A retrospective cohort study was conducted from 2022 to 2024 at Dr. Hasan Sadikin General Hospital and Regional General Hospital Prof. Dr. Margono Soekarjo. The study included 245 pregnant women diagnosed with preeclampsia who met specific inclusion criteria. Data were collected on age, body mass index (BMI), parity status, and albumin levels. Chi-square tests, relative risk, and receiver operating characteristic (ROC) curve analyses were utilized to assess the correlation between hypoalbuminemia and preeclampsia severity. Hypoalbuminemia was predominantly identified in individuals aged 31-40 years with mild to moderate hypoalbuminemia. Most participants were multiparous, obese, and presented with preeclampsia without severe features. A significant correlation (p = 0.000) was observed between hypoalbuminemia and preeclampsia severity. Pregnant women with severe hypoalbuminemia had a 4.4 times higher risk of developing preeclampsia with severe features compared to those with mild to moderate hypoalbuminemia. ROC analysis identified an albumin cut-off value of 2.51 g/dL as a predictor of preeclampsia with severe features. Hypoalbuminemia is significantly correlated with the severity of preeclampsia and may serve as a valuable predictor for identifying severe cases. Recognizing this relationship could improve the management of hypertensive disorders during pregnancy and potentially reduce maternal morbidity and mortality rates.