Effect of maternal serum albumin level on birthweight and gestational age: an analysis of 39200 singleton newborns

Jiayi Wu; Xiaorui Liu; Chuanmei Qin; Jinwen Zhang; Xueqing Liu; Jianing Hu; Fan Wu; Cailian Chen; Yi Lin

doi:10.3389/fendo.2024.1266669

Effect of maternal serum albumin level on birthweight and gestational age: an analysis of 39200 singleton newborns

Front Endocrinol (Lausanne). 2024 Mar 5:15:1266669. doi: 10.3389/fendo.2024.1266669. eCollection 2024.

Authors

Jiayi Wu^{1

2

3}, Xiaorui Liu^{1

2

3}, Chuanmei Qin^{1

2

3}, Jinwen Zhang^{1

2

3}, Xueqing Liu^{1

2

3}, Jianing Hu^{1

2

3}, Fan Wu^{1

2

3}, Cailian Chen^{4

5}, Yi Lin^{1

2

3

6}

Affiliations

¹ The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
² Shanghai Key Laboratory of Embryo Original Diseases, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
³ Institute of Birth Defects and Rare Diseases, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
⁴ Department of Automation, Shanghai Jiao Tong University, Shanghai, China.
⁵ Key Laboratory of System Control and Information Processing, Ministry of Education of China, Shanghai, China.
⁶ Reproductive Medicine Center, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.

Abstract

Background: Serum albumin plays a pivotal role in regulating plasma oncotic pressure and modulating fluid distribution among various body compartments. Previous research examining the association between maternal serum albumin levels and fetal growth yielded limited and inconclusive findings. Therefore, the specific influence of serum albumin on fetal growth remains poorly understood and warrants further investigation.

Methods: A retrospective study involved 39200 women who had a singleton live birth at a tertiary-care academic medical center during the period from January 2017 to December 2020. Women were categorized into four groups according to the quartile of albumin concentration during early pregnancy: Q1 group, ≤41.0 g/L; Q2 group, 41.1-42.6 g/L; Q3 group, 42.7-44.3 g/L and Q4 group, >44.3 g/L. The main outcome measures were mid-term estimated fetal weight, birthweight and gestational age. Multivariate linear and logistic regression analysis were performed to detect the independent effect of maternal serum albumin level on fetal growth after adjusting for important confounding variables.

Results: In the crude analysis, a significant inverse correlation was found between early pregnancy maternal serum albumin levels and fetal growth status, including mid-term ultrasound measurements, mid-term estimated fetal weight, birthweight, and gestational age. After adjustment for a number of confounding factors, mid-term estimated fetal weight, birthweight, and birth height decreased significantly with increasing albumin levels. Compared to the Q2 group, the Q4 group had higher rates of preterm birth (aOR, 1.16; 95% CI, 1.01-1.34), small-for-gestational-age (aOR, 1.27; 95% CI, 1.11-1.45) and low birthweight (aOR, 1.41; 95% CI, 1.18-1.69), and lower rate of large-for-gestational-age (aOR, 0.85; 95% CI, 0.78-0.94). Moreover, to achieve the optimal neonatal outcome, women with higher early pregnancy albumin levels required a greater reduction in albumin levels in later pregnancy stages.

Conclusions: A higher maternal serum albumin level during early pregnancy was associated with poor fetal growth, with the detrimental effects becoming apparent as early as the mid-gestation period. These findings provided vital information for clinicians to predict fetal growth status and identify cases with a high risk of adverse neonatal outcomes early on.

Keywords: birthweight; fetal growth; gestational age; mid-term fetal growth; serum albumin.

MeSH terms

Birth Weight
Female
Fetal Growth Retardation
Fetal Weight*
Gestational Age
Humans
Infant, Newborn
Pregnancy
Premature Birth*
Retrospective Studies
Serum Albumin

Substances

Serum Albumin

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the National Key Research and Development Program of China [grant number 2018YFC1002800]; the National Natural Science Foundation of China [grant numbers 82171669, 81971403]; the Innovative Research Team of High-level Local Universities in Shanghai [grant number SHSMU-ZLCX20210202]; the Shanghai Jiao Tong University Trans-Med Awards Research (STAR) (Major Project).