OS 04-03 EVALUATION OF THE DIAGNOSTIC VALUE OF THE FIRST TRIMESTER MATERNAL SERUM HIGH SENSITIVE C-REACTIVE PROTEIN (HS-CRP) LEVEL FOR PREDICTION OF PRE-ECLAMPSIA

Abstract

Objective: The purpose of the present study is to evaluate the diagnostic value of maternal serum high sensitive C-reactive protein (hs-CRP) measurement during the first trimester of pregnancy for predicting of pre-eclampsia. Design and Method: A prospective cohort study was performed on 394 pregnant women who were at the gestational age of 8–13 weeks of pregnancy. In all women serum hs-CRP was measured by latex agglutination test. The women were then monitored to delivery. Hs-CRP of the two groups, both with and without pre-eclampsia, were compared. For finding the optimum cut- off points, ROC (Receiver Operating Characteristics) curve was used. Results: Out of 394 women, 42 women (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 the normotensive groups (7.06 ± 2.6 mg/L vs 3.6 ± 2.3 mg/L, P = 0.001). Receiver Operating Characteristics curve (ROC) showed a significant difference between under curve zone of hs-CRP level with the reference line. Serum hs-CRP of 4 mg/L showed a sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) 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%) cases of normotensive pregnancies which showed a significant difference (p = 0.001, RR = 12.1, (95% CI: 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%) cases of normotensive pregnancies which showed a significant difference (p = 0.001, RR = 9.35, (95% CI: 4.48–19.52). Conclusions: Hs-CRP measurements during the first trimester of pregnancy is helpful in predicting pre-eclampsia.