ArticleBMC pregnancy and childbirth2026
Combined albumin-adjusted ischemia-modified albumin ratio and uterine artery Doppler for differentiating early-onset preeclampsia from gestational hypertension: a prospective exploratory pilot study.
Article in BMC pregnancy and childbirth, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundDistinguishing early-onset preeclampsia (EO-PE) from gestational hypertension (GHT) at initial presentation remains challenging, particularly when classical diagnostic features are absent or evolving. We evaluated whether combining the albumin-adjusted ischemia-modified albumin ratio (IMAR) with uterine artery pulsatility index expressed as multiples of the median (UtA-PI MoM) provides complementary information in this setting.
methodsIn this prospective single-center exploratory study, 90 singleton pregnancies (30 EO-PE, 30 GHT, 30 controls) were included. IMAR and UtA-PI MoM were assessed individually and in combination using receiver operating characteristic analysis and logistic regression with bootstrap internal validation.
resultsIMAR and UtA-PI MoM were higher in EO-PE than in GHT (p = 0.003 and p < 0.001, respectively), whereas raw IMA did not distinguish the groups. IMAR demonstrated moderate discrimination (AUC 0.727, 95% CI 0.600-0.854), and UtA-PI MoM demonstrated higher performance (AUC 0.844, 95% CI 0.743-0.946). The combined model showed the highest apparent discrimination (AUC 0.898, 95% CI 0.818-0.977; optimism-corrected AUC 0.889), with 83.3% sensitivity and 86.7% specificity at the exploratory operating point.
conclusionsCombining IMAR with UtA-PI MoM may provide complementary information for distinguishing EO-PE from GHT at initial presentation. This exploratory model is not intended to replace established angiogenic biomarkers and requires validation in larger, multicenter studies before clinical application.
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