The prognostic value of fibrinogen/albumin ratio and other ınflammatory ındices in preterm prelabor rupture of membranes Preterm prematür membran rüptüründe fibrinojen/albümin oranı ve diğer inflamatuar indekslerin prognostik değeri

INTRODUCTION: To investigate the ability of the fibrinogen-albumin ratio (FAR) and other combined inflammatory indices to predict adverse perinatal outcomes in cases of early preterm prelabor membrane rupture (PPROM).
METHODS: Retrospective analysis of data from patients with PPROM between 24 and 34 weeks of gestation from January to August 2025 was performed. Delivery within 48 hours, chorioamnionitis, placental abruption, intrauterine fetal demise, neonatal death, neonatal pH below seven, and neonatal sepsis were considered composite adverse perinatal outcomes (CAPO). Clinical characteristics, hemogram parameters, fibrinogen, albumin, C-reactive protein (CRP), and inflammatory indices (FAR, neutrophil-to-lymphocyte ratio (NLR), systemic inflammatory index (SII), systemic inflammatory response index (SIRI), and aggregate index of systemic inflammation (AISI)) were compared between patients with and without CAPO. The predictive accuracy of significant variables was evaluated using receiver operating characteristic (ROC) analyses.
RESULTS: Data from a total of 170 patients were included in the study. CAPO was present in 100 patients. Fibrinogen, CRP, and FAR values were higher in the CAPO group (p = 0.02, p = 0.019, and p = 0.002, respectively). The albumin level was lower in the same group (p = 0.023). No significant differences were observed between the groups regarding other laboratory parameters or inflammatory indices. CRP demonstrated higher sensitivity (71%) and lower specificity (59%) for predicting CAPO, while FAR exhibited higher specificity (73%) and lower sensitivity (58%).
DISCUSSION AND CONCLUSION: FAR, a recently developed inflammatory marker, may be a useful tool for predicting adverse outcomes in PPROM cases. In the present study, FAR outperformed hemogram-derived combined inflammatory indices in this regard.

Keywords: Preterm prelabor rupture of the membranes, adverse perinatal outcomes, fibrinogen-albumin ratio