Maternal serum highly sensitive C-reactive protein in normal pregnancy and pre-eclampsia.
ABSTRACT To establish reference values for highly sensitive C-reactive protein (hsCRP) in normal pregnancy and determine whether disease severity could be predicted by serum hsCRP concentration in women with severe pre-eclampsia (PE).
Blood samples were collected from 25 pregnant women with severe PE and 202 healthy pregnant women who were divided into 4 groups by pregnancy duration. Levels of hsCRP were determined by the immunonephelometric method. Mean arterial pressure, time between delivery and diuresis, and mean ratio of systolic to diastolic blood flow velocity in uterine arteries were used as indicators of the severity of PE.
The median values of hsCRP in each group were 0.76 mg/L (0.16-13.61 mg/L), 1.53 mg/L (0.39-20.31 mg/L), 2.08 mg/L (0.50-9.45 mg/L), and 2.28 mg/L (0.44-8.11 mg/L) and showed a trend toward increase. Serum levels of hsCRP were positively correlated with each severity indicator of PE.
This study showed that hsCRP levels were positively correlated to pregnancy duration in healthy women and could be used as a severity marker in women with severe PE.
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ABSTRACT: The purpose of the present study was to evaluate the diagnostic value of maternal serum high-sensitivity C-reactive protein (hs-CRP) measurement during the first trimester of pregnancy for predicting pre-eclampsia. A prospective cohort study was performed on 394 pregnant women who were at the gestational age of 8-13 weeks. In all women, serum hs-CRP was measured by latex agglutination test. The women were then monitored to delivery. We compared the hs-CRP of the two groups, those with and without pre-eclampsia. We used the receiver-operator curve for finding the optimum cut-off points. Out of 394 women, 42 cases (10.7%) were complicated by pre-eclampsia, of whom 23 women (56.1%) had severe pre-eclampsia. Mean serum hs-CRP of the pre-eclamptic group was higher than that of the normotensive group (7.06 ± 2.6 mg/L vs 3.6 ± 2.3 mg/L, P = 0.001). The receiver-operator curve showed a significant difference between the under-curve zone for the hs-CRP level with the reference line. Serum hs-CRP of 4 mg/L showed sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy as 78.1%, 72.1%, 25%, 96.5% and 72.8%, respectively. Hs-CRP of more than 7 mg/L was found in 26 (61.9%) cases of pre-eclampsia and 22 (6.25%) normotensive pregnancies, which showed a significant difference (P = 0.001, relative risk = 12.1, 95% confidence interval: 6.91-21.15). Hs-CRP of more than 7 mg/L was found in 17 (73.91%) cases of severe pre-eclampsia and 22 (6.25%) normotensive pregnancies, which showed a significant difference (P = 0.001, relative risk = 9.35, 95% confidence interval: 4.48-19.52). Hs-CRP measurements during the first trimester of pregnancy are helpful in predicting pre-eclampsia.Journal of Obstetrics and Gynaecology Research 07/2013; · 0.84 Impact Factor
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ABSTRACT: Objective To investigate the values of C-reactive protein (CRP) in early pregnancy for detection of any abnormality of the conceptus and especially the condition of extra-uterine pregnancy (EUP). Study design In this prospective observational study, we established reference values for CRP in early pregnancy. Next, we tested whether a single, wide-range CRP measurement could serve as a diagnostic tool for abnormal first trimester pregnancy by comparing CRP levels in three different pregnancy statuses: viable intrauterine pregnancy (Group A), EUP (Group B) and delayed abortion (Group C). Results CRP levels were significantly higher in normal pregnancy (Group A) compared to abnormal pregnancy (Group B + C and Group B alone). CRP level was influenced only by the pregnancy status (normal, EUP or delayed abortion) and not by age, BMI, hematocrit or gravidity. The multiple logistic regression model (adjusted for age, gravidity, gestational age, hematocrit and BMI) revealed CRP as being a predictor for normal intrauterine pregnancy. Conclusion This study examined the association between CRP levels and abnormal first trimester pregnancies. Our results support single CRP measurement as a diagnostic tool in early pregnancy.European journal of obstetrics, gynecology, and reproductive biology 01/2014; · 1.97 Impact Factor
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ABSTRACT: Objective To compare concentrations of C-reactive protein in patients with preeclampsia and healthy normotensive pregnant women. Method We selected 70 patients. Thirty-five patients with preeclampsia were selected as cases (group A) and 35 healthy normotensive women with the same age and body mass index as those in group A were selected as controls (group B). Blood samples were collected in all patients before labor and immediately after diagnosis in group B to determine C-reactive protein concentrations. Results C-reactive protein concentrations differed significantly between patients in the study group (group A: 6.1 ± 2.2 mg/l) and those in the control group (group B: 3.5 ± 0.8 mg/l; P<.05). There was a weak, positive and significant correlation with values of systolic blood pressure (r=.314; P<.05) and diastolic blood pressure (r=.266; P<.05). A cutoff value of 180 pg/ml had an area under the curve of 0.86, a sensitivity of 76.3%, specificity of 81.2%, positive predictive value of 82.8%, and a negative predictive value of 74.2%. Conclusions C-reactive protein concentrations were significantly higher in patients with preeclampsia than in healthy normotensive pregnant women.Clínica e Investigación en Ginecología y Obstetricia 01/2014;