Pre-Eclampsia in Women with Raised C-Reactive Protein Levels Before 20th Week of Gestation; A Cohort Study
DOI:
https://doi.org/10.51253/pafmj.v74i1.8494Keywords:
Body mass index, Pre-eclampsia, C-reactive protein, Pregnancy, ParityAbstract
Objective: To assess the association of pre-eclampsia in women with raised CRP before 20 weeks of gestation.
Study Design: Prospective cohort study,
Place and Duration of Study: Department of Obstetrics and Gynaecology, Civil Hospital, Karachi Pakistan, from Jan to Aug
2019.
Methodology: One hundred and sixty-eight women were included. 84 of 168 women had raised CRP, called as ExposedGroup, and 84 had normal CRP, called as Unexposed-Group. Blood samples were sent to assay serum CRP. Patients were thenfollowed up until the third trimester to observe whether women with elevated serum CRP >5 mg/l or women with normal levels of CRP developed pre-eclampsia.
Results: The average age of the women was 26.30±5.15 years. The pre-eclampsia was significantly high in the Exposed-Group as compared to the Unexposed-Group (p=0.019). The pre-eclampsia was two times more likely in the Exposed-Group as compared to the Unexposed-Group (RR=1.73; 95% CI 1.07-2.79).
Conclusion: Pre-eclampsia is more likely to occur before 20 weeks of pregnancy in women having raised CRP. Therefore,
effective monitoring of CRP could help in timely management and prevent severity.
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References
English FA, Kenny LC, McCarthy FP. Risk factors and effective
management of preeclampsia. Integr Blood Press Control 2015;
:7-12. https://doi.org/10.2147/ibpc.s50641.
Gyamfi-Bannerman C, Pandita A, Miller EC, Boehme AK,
Wright JD, Siddiq Z, et al. Preeclampsia outcomes at delivery
and race. J Matern Fetal Neonatal Med 2020; 33(21): 3619-3626.
https://doi.org/10.1080/14767058.2019.1581522.
Steegers EA, Von Dadelszen P, Duvekot JJ, Pijnenborg R. Preeclampsia. Lancet 2010; 376(9741): 631-644.
https://doi.org/10.1016/S0140-6736(10)60279-6.
Hamadeh R, Mohsen A, Kobeissy F, Karouni A, Akoum H. Creactive protein for prediction or early detection of preeclampsia: a systematic review. Gynecol Obstet Invest 2021: 1-14.
https://doi.org/10.1159/000515530.
Mishra N, Pradhan K, Sahoo G, Rohilla M, Meena M. Can hsCRP
be the sole investigation for predicting the severity and outcome
in women with pre-eclampsia presenting late in pregnancy?
Trop J Obstet Gynaecol 2019; 36(1): 54-60.
https://doi.org/10.4103/TJOG.TJOG_66_18.
Nehring SM, Goyal A, Bansal P, Patel BC. C Reactive Protein.
StatPearls Treasure Island (FL), StatPearls Publishing LLC; 2022.
Vecchié A, Bonaventura A, Carbone F, Maggi D, Ferraiolo A,
Carloni B, et al. C-Reactive protein levels at the midpregnancy
can predict gestational complications. Biomed Res Int 2018; 2018:
https://doi.org/10.1155/2018/1070151.
Black KD, Horowitz JA. Inflammatory markers and
preeclampsia: a systematic review. Nurs Res 2018;67(3):242-251.
https://doi.org/10.1097/NNR.0000000000000285
Kara AE, Guney G, Tokmak A, Ozaksit G. The role of
inflammatory markers hs-CRP, sialic acid, and IL-6 in the
pathogenesis of preeclampsia and intrauterine growth
restriction. Eur Cytokine Netw 2019; 30(1): 29-33.
https://doi.org/10.1684/ecn.2019.0423.
Guney G, Taskin MI, Tokmak A. Increase of circulating
inflammatory molecules in preeclampsia, an update. Eur
Cytokine Netw 2020; 31: 18-31.
https://doi.org/10.1684/ecn.2020.0443.
Rout RR, Mahalik M. Comparison of C-reactive proteins level in
gestational hypertension and in normal pregnancy in 2nd and
rd trimester and its correlation with maternal and foetal
outcome. Int J Reprod Contracep Obstet Gynecol 2019; 8(6): 2541-
https://doi.org/10.18203/2320-1770.ijrcog20192464.
Ertas IE, Kahyaoglu S, Yilmaz B, Ozel M, Sut N, Guven MA, et
al. Association of maternal serum high sensitive C‐reactive
protein level with body mass index and severity of pre‐eclampsia
at third trimester. J Obstet Gynaecol Res 2010; 36(5): 970-977.
https://doi.org/10.1111/j.1447-0756.2010.01279.x.
Ruma M, Boggess K, Moss K, Jared H, Murtha A, Beck J, et al.
Maternal periodontal disease, systemic inflammation, and risk
for preeclampsia. Am J Obstet Gynecol 2008; 198(4): 389.
https://doi.org/10.1016/j.ajog.2007.12.002.
Wang Y, Cupul-Uicab LA, Rogan WJ, Eggesbo M, Travlos G,
Wilson R, et al. Recreational Exercise Before and During
Pregnancy in Relation to Plasma C-Reactive Protein
Concentrations in Pregnant Women. J Phys Act Health 2015;
(6): 770-775. https://doi.org/10.1123/jpah.2013-0390.
Behboudi-Gandevani S, Moghadam NA, Mogadam-banaem L,
Mohamadi B, Asghari M. Association of high-sensitivity Creactive protein serum levels in early pregnancy with the
severity of preeclampsia and fetal birth weight. J Perinat Med.
; 40(6): 601-605. https://doi.org/10.1515/jpm-2011-0190.
Mihu D, Costin N, Mihu CM, Blaga LD, Pop RB. C-reactive
protein, marker for evaluation of systemic inflammatory
response in preeclampsia. Rev Med Chir Soc Med Nat Iasi 2008;
(4): 1019-1025.
Ustün Y, Engin-Ustün Y, Kamaci M. Association of fibrinogen
and C-reactive protein with severity of preeclampsia. Eur J
Obstet Gynecol Reprod Biol 2005; 121(2): 154-158.
https://doi.org/10.1016/j.ejogrb.2004.12.009.
Sharmin S, Chy S, Alam D, Banu N, Rashid F, Kabir S, et al.
Association of Serum C reactive protein in preeclampsia and its
effect on fetal birth weight A case control study. Bangladesh J
Obstet Gynaecol 2016; 31(2): 75-80.
https://doi.org/10.3329/bjog.v31i2.34214.
Ali Z, Bokhari FA, Zaki S, Zargham U, Tauseef A, Khakan S.
Correlation of CRP levels in third trimester with fetal birth
weight in preeclamptic and normotensive pregnant women. J
Coll Physicians Surg Pak 2015; 25(2): 111-114.
Spracklen CN, Smith CJ, Saftlas AF, Triche EW, Bjonnes A,
Keating BJ, et al. Genetic predisposition to elevated levels of Creactive protein is associated with a decreased risk for
preeclampsia. Hypertens Pregnancy 2017; 36(1): 30-35.
https://doi.org/10.1080/10641955.2016.1223303.
Gencheva DG, Nikolov FP, Uchikova EH, Mihaylov RD,
Pencheva BG, Ivanova KI, et al. High-sensitivity CRP levels in
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