The Role of Maternal Serum Ischemia-modified Albumin in the Prediction of Hyperemesis Gravidarum: a Prospective Cohort Study

Background: Ischemia and associated hypoxemia-induced oxidative stress play an important role in hyperemesis gravidarum (HG) pathogenesis.

Objective: The aim was to investigate the role of ischemia-modified albumin (IMA) in predicting HG.

Methods: A prospective cohort study was conducted with 138 participants with singleton pregnancies who had experienced HG in previous pregnancies. Blood samples were taken at or before 5 weeks, provided they had no symptoms of nausea and vomiting at that time. The samples were stored under appropriate conditions to be analyzed for IMA. All participants were then followed to determine whether they would develop HG.

Results: HG occurred in 42 participants (HG group), while the remaining 96 participants did not develop HG (control group). Baseline characteristics showed no significant differences. IMA levels were significantly higher in the HG group (p < 0.001). IMA levels did not correlate with body mass index or maternal age. IMA with a cut-off of >74.74 ng/mL (95% sensitivity, 67% specificity) had a discriminatory power with an AUC value of 0.791 (95% CI: 0.714-0.856;  < 0.001) for predicting HG.

Conclusion: Our results show an association between high IMA levels in early pregnancy and an increased risk of HG. IMA can be used as a predictive tool for HG.