The relationship between D-dimer to fibrinogen ratio,fibrinogen to albumin ratio and the outcome of fetal protection in patients with recurrent spontaneous abortion

He Ruili; Chen Yibing

doi:10.3760/j.issn.1673-4777.2025.12.014

Abstract：Objective To investigate the relationship between D-dimer to fibrinogen ratio(DFR),fibrinogen to albumin ratio(FAR)and the outcome of fetal protection in patients with recurrent spontaneous abortion(RSA).Methods A total of 100 patients with RSA in the First Affiliated Hospital of Zhengzhou University from May 2022 to November 2024 were selected as the observation group,and 100 healthy pregnant women in the same period were selected as the control group according to 1∶1 matching.The DFR and FAR of the two groups were compared,and the clinical data,DFR and FAR of patients with different tocolysis outcomes in the observation group were compared.Logistic regression was used to analyze the influencing factors of tocolysis outcomes in RSA patients,and restricted cubic spline was used to analyze the nonlinear relationship between DFR,FAR and tocolysis outcomes in RSA patients.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of DFR and FAR for the outcome of RSA.Results The DFR and FAR of the observation group were higher than those of the control group[(0.29±0.06)vs(0.15±0.04),(0.25±0.05)vs(0.12±0.03)](t=19.415,22.295,both P＜0.05).The previous history of induced abortion,the proportion of abortion times＞3,DFR and FAR of patients with failed tocolysis were higher than those of patients with successful tocolysis,and the proportion of more previous abortion time was lower than that of patients with successful tocolysis(all P＜0.05).Before and after propensity score matching method was used to adjust the variables such as previous history of induced abortion,number of abortions,and time of tocolation,Logistic regression analysis showed that DFR and FAR were the influencing factors of tocolation outcome in RSA patients(both P＜0.05).The levels of DFR and FAR had a nonlinear relationship with the risk of failed tocolysis in RSA patients(both P＜0.05).When DFR≥0.25 and FAR≥0.20,the risk of failed tocolysis in RSA patients increased with the increase of DFR and FAR levels(both P＜0.05).The results of ROC analysis showed that the area under the curve of DFR,FAR alone and in combination to predict the tocolysis outcomes in RSA patients was 0.752,0.745 and 0.881,respectively.Conclusion DFR and FAR have a nonlinear relationship with the outcome of fetal protection in RSA patients.When DFR≥0.25 and FAR≥0.20,the risk of fetal protection failure in RSA patients increases,and the two can be used to assist in evaluating the outcome of fetal protection in patients.