C-Reactive Protein Levels at the Midpregnancy Can Predict Gestational Complications.

Alessandra Vecchié,Gabriella Andraghetti,Beatrice Carloni,Antonella Ferraiolo,Laura Affinito Bonabello,Fabrizio Montecucco,Franco Dallegri,Aldo Bonaventura,Davide Maggi,Luca Liberale,Renzo Cordera,Federico Carbone

doi:10.1155/2018/1070151

Alessandra Vecchié, Gabriella Andraghetti + Show 10 more

Open Access

https://doi.org/10.1155/2018/1070151

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Abstract

Although essential for a successful pregnancy, a growing body of evidence suggests that maternal inflammation, when dysregulated, may represent a risk factor for both maternal and neonatal outcomes. Here, we assessed the accuracy of maternal C-reactive protein (CRP) concentrations at the middle phase of pregnancy in the identification of maternal adverse outcomes (MAO) until delivery. A correlation between CRP and a complicated pregnancy including both maternal and neonatal adverse outcomes has been investigated, too. In this retrospective study, conducted at the Diabetology Unit of IRCCS Ospedale Policlinico San Martino, Genoa (Italy), 380 outpatient pregnant women have been enrolled at the prenatal visit before performing a 75 g oral glucose tolerance test at 24th-26th gestational week for gestational diabetes mellitus (GDM) screening. Demographic, medical, and reproductive history has been obtained by verbal interview. Data about pregnancy and delivery have been retrieved from medical records. The median value of maternal baseline serum CRP was 3.25 μg/mL. Women experiencing MAO were older, more frequently suffering from hypertension, and showed higher CRP concentrations, with a cutoff value >1.86 μg/mL found by a ROC curve analysis to be accurately predictive for MAO. By a logistic regression analysis, serum CRP levels >1.86 μg/mL have been found to predict MAO also considering maternal age, hypertension, and GDM. Maternal CRP levels have been positively associated with overall pregnancy adverse outcomes (maternal and neonatal), too. In conclusion, in pregnant women serum levels of CRP can early recognize subjects at higher risk for maternal and neonatal complications needing a more stringent follow-up.

Highlights

Inflammation is an essential element for a successful pregnancy [1]
The topic has been largely investigated, the purpose of this study is to examine whether maternal serum C-reactive protein (CRP) concentrations in a specific period of the pregnancy—the middle phase—may help in predicting late gestational complications until delivery, considering the large diffusion and the extreme easiness in measuring this biomarker, largely validated in the cardiovascular field
We evaluated the characteristics of the overall cohort by Demographic and clinical characteristics Age at enrollment, years (IQR) CRP∗, μg/mL (IQR) Ethnicity

Summary

Introduction

Inflammation is an essential element for a successful pregnancy [1]. Inflammatory processes are involved in implantation and decidualization during early stages of pregnancy, and in the uterine activation during labor [1,2,3]. In the middle phase of gestation, a quiescence of inflammation is required to ensure maternal tolerance for fetal antigens [4]. A growing body of evidence suggests that a dysregulated maternal inflammation during pregnancy might be a possible risk factor for several neonatal complications [5, 6]. Some studies have found a correlation between inflammation and the development of gestational complications [7, 8]. The identification of a low-cost and easy-to-measure biomarker of maternal inflammation able to predict risk for complicated

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