Perinatology logo

Albumin — Pregnancy Reference Values

Perinatology.com › Reference › Serum › Albumin

Albumin — serum

Serum albumin normally decreases across pregnancy due to hemodilution and expansion of plasma volume. Mild hypoalbuminemia is common and usually physiologic.

Units Nonpregnant Female 1st Trimester 2nd Trimester 3rd Trimester
g/dL 4.1 – 5.3 3.1 – 5.1 2.6 – 4.5 2.3 – 4.2
g/L 41 – 53 31 – 51 26 – 45 23 – 42
Causes of elevated albumin
  • Hemoconcentration / fluid loss
    • Dehydration (vomiting, diarrhea, poor intake)
    • Severe hyperemesis gravidarum
    • Burns or excessive diuresis
  • Reduced plasma volume
    • Congestive heart failure
    • Shock states
  • Medication-related
    • Glucocorticoid excess
  • Pregnancy-specific considerations
    • High albumin is rare in pregnancy and typically reflects dehydration.
Causes of low albumin (hypoalbuminemia)
  • Physiologic in pregnancy
    • Hemodilution
    • Expanded plasma volume (1–1.5 g/dL decrease)
  • Decreased hepatic synthesis
    • Chronic liver disease or cirrhosis
    • Acute hepatitis
    • Severe malnutrition
  • Increased losses
    • Kidney disease (proteinuria, nephrotic syndrome)
    • Protein-losing enteropathy
    • Severe burns
  • Pregnancy-associated disorders
    • Preeclampsia
    • HELLP syndrome
    • Acute fatty liver of pregnancy
    • Hyperemesis gravidarum
  • Endocrine
    • Hypothyroidism

References

  1. Abbassi-Ghanavati M, Greer LG, Cunningham FG. Pregnancy and laboratory studies: a reference table for clinicians. Obstet Gynecol. 2009;114:1326–31.
  2. Wallach J. Interpretation of Diagnostic Tests, 8th ed.
  3. Fischbach FT, Dunning MB. A Manual of Laboratory and Diagnostic Tests, 7th ed.