C-Reactive Protein Levels at the Midpregnancy Can Predict Gestational Complications

Abstract

Although essential for a successful pregnancy, a growing body of evidence suggests that maternal inflammation, when dysregulated, may represent a risk factor for both maternal and neonatal outcomes. Here, we assessed the accuracy of maternal C-reactive protein (CRP) concentrations at the middle phase of pregnancy in the identification of maternal adverse outcomes (MAO) until delivery. A correlation between CRP and a complicated pregnancy including both maternal and neonatal adverse outcomes has been investigated, too. In this retrospective study, conducted at the Diabetology Unit of IRCCS Ospedale Policlinico San Martino, Genoa (Italy), 380 outpatient pregnant women have been enrolled at the prenatal visit before performing a 75 g oral glucose tolerance test at 24th-26th gestational week for gestational diabetes mellitus (GDM) screening. Demographic, medical, and reproductive history has been obtained by verbal interview. Data about pregnancy and delivery have been retrieved from medical records. The median value of maternal baseline serum CRP was 3.25 μg/mL. Women experiencing MAO were older, more frequently suffering from hypertension, and showed higher CRP concentrations, with a cutoff value >1.86 μg/mL found by a ROC curve analysis to be accurately predictive for MAO. By a logistic regression analysis, serum CRP levels >1.86 μg/mL have been found to predict MAO also considering maternal age, hypertension, and GDM. Maternal CRP levels have been positively associated with overall pregnancy adverse outcomes (maternal and neonatal), too. In conclusion, in pregnant women serum levels of CRP can early recognize subjects at higher risk for maternal and neonatal complications needing a more stringent follow-up.

Proteome profiling of gestational diabetes mellitus at 16‐18 weeks revealed by LC‐MS/MS

“…Additionally, chronic low‐grade inflammation in adipose tissue impairs insulin signaling, which further stimulates expression of genes encoding proteins involved in insulin resistance. In this study, significant change of C‐reactive protein in 16‐18 gestational weeks may verify its role as early pregnancy predictor for developing GDM 28,29 and co‐regulations of this protein with proteins in inflammation and membrane proteins may indicate the way it works.…”

Glucocorticoid receptor sensitivity in early pregnancy in an African American cohort

“…Other analyses have found elevated CRP among pregnant women who deliver preterm 24,47‐50 . There is a growing literature supporting a role for harmful social and structural factors in the association between African American race and preterm birth 50‐52 .…”

Antiapolipoprotein A-1 Autoantibody Positivity Is Associated with Threatened Abortion

“…Study Population and Clinical Assessment. As previously described [3], 380 consecutive outpatient pregnant women between the 24 th and 26 th gestational week (gestational age 23 weeks + 0 days-25 weeks + 6 days) aged 18 or older attending the Diabetology Unit of IRCCS Ospedale Policlinico San Martino (Genoa, Italy) were enrolled from October 2012 to November 2014. No other specific inclusion criteria than a pregnant status were established, while exclusion criteria consisted in clinical suspicion of an active infection or concurrent treatment with corticosteroids (n = 9), thus leaving 371 patients eligible for analyses.…”

“…Furthermore, in approximately 1-6% of healthy women, the presence of high levels of APL autoantibodies can be detected and can potentially affect physiological pregnancy [1,2]. As well, we recently found that even moderately high levels of C-reactive protein (CRP), a classical biomarker of systemic inflammation, can help in recognizing pregnant women at increased risk for adverse outcomes [3], thus highlighting the pivotal effect that inflammation may have during pregnancy.…”

“…In APS and SLE, APL autoantibodies were shown to be associated with antibodies against apolipoprotein A-1 (anti-ApoA-1 IgG), the major fraction of high-density lipoproteins, and such association may be explained by a certain degree of cross-reactivity between APL and anti-ApoA-1 antibodies [3,4]. The seropositivity for the latter antibodies is fairly prevalent in the general population (approximately 20%) and represents an independent predictor of death and acute cardiovascular events associated with vascular inflammation [4,5].…”