Associations between Serum CRP Concentration, Maternal Hypertension, and Fetal Outcome: A Comparative Analysis in Pregnant Women

Abstract

Introduction: Pre-eclampsia is a complex disorder characterized by hypertension and proteinuria after 20 weeks of gestation, posing risks to maternal and fetal health. It is linked to adverse outcomes worldwide, with varying incidence rates across regions. Risk factors include history, maternal age, and socioeconomics. The pathophysiology involves issues with spiral artery adaptation. The study aimed to analyze the associations between serum CRP concentration, maternal hypertension, and fetal outcomes in pregnant women. Methods: This cross- sectional analytical study was conducted at the Department of Obstetrics and Gynecology at the Institute of Child and Mother Health (ICMH), Matuail, Dhaka. It took place from January to December 2018. The study population comprised 120 pregnant women within the gestational age of 28-40 weeks. The women were categorized into three groups: Group A (control) consisted of normotensive pregnant women, Group B included pregnant women with mild pre-eclampsia, and Group C comprised pregnant women with severe pre-eclampsia. Ethical guidelines were followed, including IRB approval and participant consent. Data were analyzed using SPSS software, version, 22.0. Chi-Square, t-test, and ANOVA test were performed to determine associations among the study variables of the groups, where p<0.05 considered as the level of significance. Results: The study enrolled 120 participants divided into Groups A, B, and C. The majority fell within the 18-25 age range. The mean ages were 24.23±4.52 (Group A), 24.73±4.01 (Group B), and 24.26±3.07 (Group C). BMI was significantly higher in Groups A and B compared to Group C (p < 0.05). Gestational age was lower in mild and severe preeclampsia compared to normal pregnancies (p < 0.05). Cesarean section delivery was significantly more frequent in preeclamptic mothers (p < 0.001). CRP levels varied, with means of 3.07 (Group A), 9.67 (Group B), and 13.15 (Group C), showing significant differences (p < 0.05). Fetal birth weight was lowest in Group C (2.61) and highest in Group A (2.95). Severe preeclampsia patients had elevated CRP levels, with 93.3% exhibiting this trend (p < 0.05). Adverse neonatal outcomes were more common in preeclampsia cases, including prematurity, LBW, and neonatal complications (p < 0.05). Increased CRP levels were associated with low birth weight (p < 0.001) and lower APGAR scores (p < 0.01). Conclusion: Pre- eclampsia shows raised serum CRP levels, particularly pronounced in severe cases, with about 83% of patients affected. This heightened CRP connects to adverse fetal outcomes.