Which hepatic protein decreases by mid-pregnancy?

• A. Albumin decreases by about 1 g/dL
• B. Gamma globulins increase by 1 g/dL
• C. Total protein increases by 1 g/dL
• D. Fibrinogen decreases by 1 g/dL

Answer: (A)

During pregnancy, plasma volume expands significantly, which dilutes circulating proteins produced by the liver. Albumin is the most notable with a drop of about 1 g/dL by mid-pregnancy. This decrease reflects physiologic hemodilution and helps explain why albumin levels fall as pregnancy progresses. In contrast, fibrinogen tends to rise as part of a hypercoagulable state to protect against postpartum hemorrhage, gamma globulins don’t show a fixed, consistent decrease, and total protein doesn’t simply increase by a fixed amount—it's influenced by changes in multiple proteins, with albumin specifically decreasing. Therefore, the hepatic protein that decreases by mid-pregnancy is albumin.