Association of high-sensitivity C-reactive protein serum levels in early pregnancy with the severity of preeclampsia and fetal birth weight

Abstract

Abstract Objective: The aim of this study was to investigate the association between high-sensitivity C-reactive protein (hs-CRP) serum levels in early pregnancy with the severity of preeclampsia (PE) and birth weight. A prospective cohort study was conducted in Noor City (in the north of Iran) from February 2008 to March 2009. The maternal serum hs-CRP levels were measured in 778 healthy pregnant women between 14 and 20 weeks of gestation. They were followed up to delivery. The women were divided into three groups according to ACOG criteria: mild and severe PE and normal group. In total, 63 (8.1%) of the subjects developed PE: 30 (3.9%) mild and 33 (4.2%) severe PE. Mean±SD hs-CRP levels in mild (7.2±2.2 mg/L) and severe (9.4±3.9 mg/L) PE were significantly higher than the normal group (2.5±2.7 mg/L). Mean±SD birth weights in severe (3100±590 g) and mild (3150±742 g) PE were significantly lower than uncomplicated pregnancies (3340±590 g). Multiple and linear logistic regression analysis showed that there were significant relationships between hs-CRP levels in mild (odds ratio, 1.66; 95% confidence interval, 1.43-1.93) and severe PE (odds ratio, 2.35, 95% confidence interval, 1.90-2.92) and with birth weight (P<0.001). The receiver operator characteristic curve showed that hs-CRP >4.5 and >5 mg/dL could predict mild and severe PE, respectively. At this level, sensitivity and specificity for mild PE were 100% and 80.7%, and for severe PE were 93.9% and 75.7%, respectively. hs-CRP can be useful in identifying pregnant women at risk for PE and low-birth weight infants.