A prospective study of maternal serum C-reactive protein concentrations and risk of preeclampsia

Qiu, Chunfang; Luthy, David A.; Zhang, Cuilin; Walsh, Scott W.; Leisenring, Wendy M.; Williams, Michelle A.

doi:10.1016/j.amjhyper.2003.09.011

Cited by 120 publications

(113 citation statements)

References 24 publications

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“…45 However, obesity, which is by itself an inflammatory condition, confounded these observations. 46,47 Although AHSG can slightly modulate body mass, 48 the low serum level of this protein was independently associated with an increased risk of preeclampsia in our study. Nevertheless, the large overlap in serum AHSG and CRP levels between preeclamptic patients and healthy pregnant womenreflected also by sensitivity and specificity values-suggests that mechanisms other than systemic inflammation are also involved in the pathogenesis of this multifactorial disorder.…”

Section: Discussionmentioning

confidence: 56%

Preeclampsia is associated with decreased serum α2-HS glycoprotein (fetuin-A) concentration

et al. 2009

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The purpose of this study was to determine serum a 2 -HS glycoprotein (AHSG) concentration and its diagnostic accuracy in preeclampsia. In this case-control study, the serum C-reactive protein (CRP) and AHSG levels were measured in 93 preeclamptic patients and in 127 healthy pregnant women by immunoturbidimetry and radial immunodiffusion. The serum CRP levels were significantly higher, whereas the serum AHSG concentrations were significantly lower in the preeclamptic group than in the control group (median (25th to 75th percentile), CRP: 6.71 mg l À1 (2.76-12.69) vs. 3.38 mg l À1 (1.69-7.27), respectively; AHSG: 660 lg ml À1 (612-768) vs. 744 lg ml À1 (660-816), respectively; Po0.001 for both). In preeclamptic patients, the serum AHSG concentrations showed significant inverse correlations with systolic blood pressure and serum CRP levels. A low serum AHSG level (p720 lg ml À1 ) was significantly associated with preeclampsia (adjusted odds ratio (95% confidence interval): 3.69 (1.82-7.51); Po0.001). According to the receiver operating characteristic curves, the measurement of serum AHSG concentrations was as accurate as that of serum CRP levels to detect preeclampsia. In conclusion, serum AHSG concentration is decreased and reflects-at least partly-systemic inflammation in preeclampsia.

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Section: Discussionmentioning

confidence: 56%

Preeclampsia is associated with decreased serum α2-HS glycoprotein (fetuin-A) concentration

et al. 2009

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“…Several studies in the literature confirm that exaggerated inflammation, specifically chronic low-grade inflammation, is one biological pathway linked to adverse pregnancy outcomes. 26,[86][87][88] The majority of the research has focused on the third trimester when most women experience myriad physical and psychosocial changes. These include a dramatic increase in body size, physical discomfort, frequent need to urinate, nausea and backache, an increase in restless legs syndrome, as well as sleep disordered breathing.…”

Section: Discussionmentioning

confidence: 99%

Identifying Insomnia in Early Pregnancy: Validation of the Insomnia Symptoms Questionnaire (ISQ) in Pregnant Women

Okun

Buysse

Hall

2015

Journal of Clinical Sleep Medicine

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Study Objectives: Although a substantial number of pregnant women report symptoms of insomnia, few studies have used a validated instrument to determine the prevalence in early gestation. Identifi cation of insomnia in pregnancy is vital given the strong connection between insomnia and the incidence of depression, cardiovascular disease, or immune dysregulation. The goal of this paper is to provide additional psychometric evaluation and validation of the Insomnia Symptom Questionnaire (ISQ) and to establish prevalence rates of insomnia among a cohort of pregnant women during early gestation. Methods: The ISQ was evaluated in 143 pregnant women at 12 weeks gestation. The internal consistency and criterion validity of the dichotomized ISQ were compared to traditional measures of sleep from sleep diaries, actigraphy, and the Pittsburgh Sleep Quality Index using indices of sensitivity, specifi city, positive and negative predictive value (PPV, NPV), and likelihood ratio (LR) tests. Results: The ISQ identifi ed 12.6% of the sample as meeting a case defi nition of insomnia, consistent with established diagnostic criteria. Good reliability was established with Cronbach α = 0.86. The ISQ had high specifi city (most > 85%), but sensitivity, PPV, NPV, and LRs varied according to which sleep measure was used as the validating criterion. Conclusions: Insomnia is a health problem for many pregnant women at all stages in pregnancy. These data support the validity and reliability of the ISQ to identify insomnia in pregnant women. The ISQ is a short and cost-effective tool that can be quickly employed in large observational studies or in clinical practice where perinatal women are seen. 1 Among the many sleep complaints associated with pregnancy, diffi culty initiating or maintaining sleep or unrefreshing sleep, are the most frequently reported issues .1,2 Collectively these sleep symptoms comprise only one aspect of clinical insomnia. According to diagnostic criteria for insomnia, one must have: (1) a diffi culty initiating or maintaining sleep, and/or unrefreshing sleep despite adequate opportunity for sleep; (2) the duration of the sleep complaint is at least 1 mo; and (3) complaints of significant impairment in social, occupational, or daily functioning. 3,4 Insomnia is associated with activation of the stress system resulting in autonomic hyperarousa l. 5,6 It is also linked to various morbidities including depressi on.7-12 Emerging evidence implicates autonomic hyperarousal as a pathway through which the risk of depression is augmen ted. 13 This association is particularly relevant for pregnant women because there is evidence that depression is associated with an increased risk for preterm birth ( PTB), 14 and prenatal depression negatively impairs maternal-child bonding and neurocognitive develo pment.14-17 Having a simple diagnostic tool to identify clinical insomnia in pregnant women could be a fi rst step in reducing the incidence of depression, autonomic hyperarousal, as well as adverse pregnancy outcomes, such as PT...

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“…The Omega study is an on-going prospective cohort study of maternal dietary risk factors of preeclampsia and other complications of pregnancy (4,6). The study population is comprised of women attending prenatal care clinics affiliated with Swedish Medical Center and Tacoma General Hospital in Seattle and Tacoma, Washington, respectively.…”

Section: The Omega Studymentioning

confidence: 99%

Maternal erythrocyte omega-3 and omega-6 fatty acids, and plasma lipid concentrations, are associated with habitual dietary fish consumption in early pregnancy

Williams

Frederick

Qiu

et al. 2006

Clinical Biochemistry

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Objectives-We investigated the relationship between selected maternal erythrocyte omega-3 and omega-6 polyunsaturated fatty acids (PUFA) and plasma lipids in early pregnancy and reported habitual fish consumption during the periconceptional period.Design and Methods-This cohort study included 923 pregnant women who reported periconceptional dietary habits and provided a blood sample before 20 weeks gestation. PUFA was determined by gas chromatography and plasma lipids by standard enzymatic methods. Differences in erythrocyte PUFA and plasma lipid concentrations were estimated using linear regression.Results-Mean erythrocyte eicosapentaeonic acid and other PUFA content (%/total) were positively associated with frequency of self-reported fish consumption. Arachidonic acid was inversely related with frequent fish consumption (p trend <0.001). Women who consumed fish > twice/week had lower plasma triglyceride (−11.5 mg/dl) and higher HDL-cholesterol (+2.8 mg/dl) concentrations than women consuming fish < once/week.Conclusions-These results support findings of inverse relation between fish consumption and preeclampsia risk.

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A prospective study of maternal serum C-reactive protein concentrations and risk of preeclampsia

Cited by 120 publications

References 24 publications

Preeclampsia is associated with decreased serum α2-HS glycoprotein (fetuin-A) concentration

Preeclampsia is associated with decreased serum α2-HS glycoprotein (fetuin-A) concentration

Identifying Insomnia in Early Pregnancy: Validation of the Insomnia Symptoms Questionnaire (ISQ) in Pregnant Women

Maternal erythrocyte omega-3 and omega-6 fatty acids, and plasma lipid concentrations, are associated with habitual dietary fish consumption in early pregnancy

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