Levels of C-reactive protein in pregnant women who subsequently develop pre-eclampsia.

Abstract

To investigate whether a maternal inflammatory response precedes the development of preeclampsia. Cross-sectional study. Antenatal clinic in an inner city teaching hospital. Two groups of women were examined at 23-25 weeks of gestation. The first group (45 women) had normal uterine artery Doppler waveforms and subsequently had a normal pregnancy outcome. The second group (45 women) had Doppler evidence of impaired placental perfusion and 21 (47%) of them had normal outcome, 14 (31%) developed intrauterine growth restriction and 10 (22%) developed pre-eclampsia, with or without intrauterine growth restriction. C-reactive protein, an acute-phase reactant, was measured in maternal serum using a highly sensitive method with a detection limit of 0.05 mg/L. Development of pre-eclampsia, as defined by the International Society for the Study of Hypertension in Pregnancy. Intrauterine growth restriction was defined as birthweight <5th centile for gestation and sex of the neonate. The serum C-reactive protein concentration in women who subsequently developed pre-eclampsia (median 1.56, range 0.55-3.12 mg/L) or delivered a baby with birthweight <5th centile (median 0.74, range 0.64-1.58 mg/L) was not significantly different from that in women with uncomplicated pregnancies (median 1.28, range 0.75-2.08 mg/L; P = 0.95 and P = 0.62, respectively). These findings suggest that the onset of clinical signs of pre-eclampsia may not be preceded by a maternal inflammatory response, as assessed by measurement of C-reactive protein.