The Effect of ALBI and APRI Scores on the Relationship With Hyperemesis Gravidarum Severity

This study aimed to evaluate the relationship between hyperemesis gravidarum (HG) severity and liver-related indices-Albumin-Bilirubin (ALBI) and Aspartate Aminotransferase to Platelet Ratio Index (APRI)-to explore their potential as non-invasive biomarkers in HG.

A retrospective cohort study was conducted on 100 pregnant women, including 66 diagnosed with HG and 34 healthy controls. Demographic, biochemical, and clinical parameters were collected from hospital records. HG severity was categorized based on ketonuria levels. ALBI and APRI scores were calculated using standard formulas. Statistical analyses were performed to assess group differences, correlation with disease severity, and diagnostic performance via ROC curve analysis.

AST levels were significantly higher in the HG group (42.7 ± 15.0 U/L) compared to controls (14.8 ± 3.0 U/L) (p < 0.001). Platelet counts were significantly lower in HG patients (281.6 ± 49.3 × 10⁹/L vs. 420.5 ± 44.7 × 10⁹/L; p < 0.001). Total bilirubin (p = 0.004) and direct bilirubin (p = 0.022) levels were also significantly elevated. ALBI scores were higher in the HG group (-2.7 ± 0.4 vs. -2.9 ± 0.3; p = 0.027), as were APRI scores (0.4 ± 0.2 vs. 0.2 ± 0.2; p < 0.001). Both indices increased progressively with ketonuria severity. ROC analysis showed APRI had an AUC of 0.740 (76% sensitivity, 71% specificity), while ALBI had an AUC of 0.647 (69% sensitivity, 63% specificity).

ALBI and APRI scores are significantly associated with the severity of HG and may reflect hepatic involvement during the disease course. These scores could serve as accessible, cost-effective, and non-invasive tools to assist in the diagnosis, risk stratification, and clinical monitoring of HG in obstetric settings.