Role of C-Reactive Proteins at Early Gestational Age in Predicting Pre-Eclampsia in Pregnant Females

Abstract

Background: Pre-eclampsia remains a significant concern in obstetrics due to its potential complications for both mother and fetus. Early detection of pre-eclampsia (PE0 is crucial for timely intervention and management. C-Reactive Protein (CRP), an inflammatory marker, has shown promise as a potential predictor of pre-eclampsia when assessed during early gestational age. Objective: To evaluate the diagnostic accuracy of raised serum CRP levels in early gestation to predict the risk of pre-eclampsia in pregnant females. Study Design: Prospective validation Study. Settings: Outdoor Department of obstetrics and gynecology, Lady Atchison Hospital Lahore. Duration: 02-September 2021 to 01-March-2022. Methods: A total of 130 pregnant females having gestational age 16 to 20 weeks and presenting in the hospital for regular antenatal visits were included. A five ml venous blood sample was drawn and was sent to the central hospital laboratory for determination of CRP levels from each case. Patients having CRP ≥5.0 mg/L were labelled as high risk of pre-eclampsia. All patients followed till delivery to determine the development of pre-eclampsia. Results: The mean age of the patients was found to be 28.16±4.74 years, with a mean BMI of 26.27±5.05 kg/m². Among the 130 patients, 12 (9.23%) were identified as having elevated CRP levels, while the remaining 118 (90.77%) showed normal CRP levels. Additionally, pre-eclampsia was diagnosed in 11 (8.46%) of the patients. Evaluation of the diagnostic accuracy of CRP levels revealed a sensitivity of 81.8% and specificity of 97.5%. The positive predictive value (PPV) was calculated at 75%, while the negative predictive value (NPV) stood at 98.3%. Conclusion: The study observed that elevated CRP levels in early pregnancy serve as a significant predictor of pre-eclampsia, with sensitivity of 81.8%, indicating its ability to correctly identify those with pre-eclampsia, while the specificity was 97.5%, suggesting its accuracy in ruling out those without the condition.