In multivariable Cox regression models adjusted for maternal age, BMI, gestational age at diagnosis, serum ALB, total protein, CRP, and comorbidities (including diabetes, thyroid disorders, or chronic hypertension), the BMI/TP ratio remained an independent predictor of pregnancy survival (HR = 0.30, 95% CI 0.16–0.57, P < .001). Here, ALB is linked to thyroid gland disorder.