Clinical significance of serum albumin level in pregnancy-related hypertension

Aim: To evaluate the usefulness of serum albumin level as a marker of severity in pregnancy-related hypertension.

Methods: Of 454 patients with pregnancy-related hypertension who were admitted to Kyungpook National University Hospital between May 1999 and April 2008, the medical records and laboratory tests of 354 patients who met the inclusion criteria for the current study were reviewed. A comparison of the characteristics of each hypertension group and the correlation between serum albumin levels and the time to delivery, 24-h urine protein, and/or pregnancy outcomes were statistically analyzed using SPSS 12.0 (SPSS Korea, Korea).

Results: Serum albumin level had a negative correlation with 24-h urine protein (Pearson's correlation coefficient = -0.481) and a positive correlation with time to delivery (= 0.389). Serum albumin ≤3.0 g/dL was highly associated with severe proteinuria (>2 g/day). There were significant differences in maternal or perinatal morbidity as a function of serum albumin level. If serum albumin level fell below 2.5 g/dL, the risks of ascites, hemolysis elevated liver enzyme low platelet (HELLP) syndrome and perinatal mortality significantly increased (odds ratio [OR] and 95% confidence interval [CI]: 3.5 [1.5-8.1], 12 [3.1-45], and 6.1 [1.7-22], respectively).

Conclusion: Serum albumin level in pregnancy-related hypertension is a significant determinant of disease severity and may be considered as a useful marker for predicting time to delivery, severe proteinuria, and pregnancy outcomes.