Relation between maternal C–reactive protein in early pregnancy and neonatal complications

Abstract

Background C-reactive protein (CRP) is an acute-phase reactant and a commonly employed indicator of low-grade systemic inflammation. Elevated CRP levels are accompanied by higher risk of popular diseases. This study aimed to study the correlations of maternal CRP level with fetal growing and the risk of neonatal complications. Participants and methods This prospective observational randomized study was conducted in Al Zahraa University and El Sheikh Zayed hospital throughout the interval from April 2018 to March 2020. It included 150 pregnant women attending for antenatal care in the outpatient clinic. CRP was done twice. The first measure was done at second trimester (13–20 weeks), and the second measure was done after 26 weeks. Positive results were obtained at a CRP concentration above 10 mg/l. The pregnant women were subdivided into two groups: group A, with positive (high) CRP, and group B, with negative (ordinary CRP). Follow-up was done by ultrasound during pregnancy [to detect Intrauterine Growth Restriction (IUGR), low birth weight, and congenital anomalies]. Follow-up during labor was done to detect mode of delivery, IUGR, respiratory distress, and NICU admission. Results Median CRP level at 13–20 weeks was higher than median CRP level at 26–30 weeks. Regarding CRP finding, it was found that ∼60 (40%) women had positive CRP and 90 (60%) women had negative CRP. IUGR was statistically significantly higher among positive CRP group than negative CRP group (5 and 0%, respectively; P=0.031). Respiratory distress was statistically significantly higher among positive CRP group than negative CRP group (6.7 and 0%, respectively) (P=0.01). Admission at neonatal ICU was statistically significantly higher among positive CRP group than negative CRP group (6.7 and 0%, respectively; P=0.031). Conclusion Maternal-grade inflammation in pregnancy, as estimated by CRP counts, was accompanied with fetal growing restriction and higher risks of neonatal complications.