High-Sensitivity C-Reactive Protein in Umbilical Cord of Small-for-Gestational-Age Neonates

Abstract

Background: Several epidemiological studies reported a significant correlation between low birth weight and cardiovascular disease in adult life. Recent studies showed that an inflammatory response has been associated with the development of atherosclerosis. High-sensitivity C-reactive protein (hs-CRP) has been demonstrated to be a sensitive marker of this inflammatory process giving prognostic information in apparently healthy general population as well as in patients with symptomatic atherosclerosis.We hypothesized that the chronic inflammatory process, involved in the future atherosclerotic injury, could be found during the fetal period. Objectives:To compare umbilical cord hs-CRP concentrations between small-for-gestational-age (SGA) and appropriate-for-gestational age (AGA) neonates. Methods: Concentrations of hs-CRP (Dade Boehring®) were measured in 35 SGA infants (gestational age: mean ± SD, 34.6 ± 3.0 weeks) and in 69 AGA neonates (34.2 ± 3.4 weeks). Neonates with a history of suspected or proven feto-maternal infection were excluded. Results: In SGA infants, hs-CRP concentrations were significantly higher than in AGA neonates: median (range); 0.06 mg/l (0.02–5.53) vs. 0.02 mg/l (0.02–0.55); p = 0.003. Concentrations of hs-CRP were higher than the detection limit (0.04 mg/l) in 25 (71.5%) SGA infants and in 28 (40.6%) AGA neonates (p = 0.002). Conclusions: In SGA infants, hs-CRP concentrations are higher than in AGA neonates suggesting the presence of an inflammatory process in this group of patients during the fetal life. This finding could be involved in the previously reported relationship between low birth weight and cardiovascular disease in adult life.

Increased cord serum inflammatory markers in small-for-gestational-age neonates

“…The production of TNF-a stimulates the apoptosis of placental trophoblasts associated with pregnancies complicated by IUGR. 7 Similar to our findings, Trevisanuto et al 12 showed that, in SGA infants, CRP concentrations are higher than those in AGA neonates, suggesting the presence of an inflammatory process in this group of patients during the fetal life.…”

Maternal Diet, C-Reactive Protein, and the Outcome of Pregnancy

“…There are limited data on hsCRP and SGA. First-trimester levels of hsCRP were higher in gravidae with SGA (n ¼ 9) or preeclampsia (n ¼ 6) [27] or in cord blood from SGA neonates [28]. Given that systemic inflammation is increased with preeclampsia [20], one might also expect to find higher hsCRP.…”

“…Prior observational studies suggested that diets high in red meat, fatty dairy products, and refined carbohydrates were associated with increased CRP [5,31], while diets high in fiber correlated with lower levels [7,31]. Some [6,28] but not all [32,33] investigators reported that a high dietary glycemic index or load was associated with increased CRP, a relationship one study found only among the women [34]. When cholesterol intakes were increased for individuals on a National Cholesterol Education Step 1 diet, CRP levels rose in the lean participants with normal glucose tolerance but not in others [35].…”

Arterial wall thickness and blood pressure in children who were born small for gestational age: correlation with umbilical cord high-sensitivity C-reactive protein

“…For this follow-up phase of the study, we considered 50 children who had taken part in a previous investigational study on umbilical cord hs-CRP 7. Serum hs-CRP was obtained at birth from umbilical cord samples and measured by an immunonephelometric method (Dade Boehring, Marburg, Germany) applied to BN II (Dade Boehring) which employs polystyrene particles coated to monoclonal antibodies specific to human CRP.…”

“…At birth, high sensitivity-C reactive protein (hs-CRP), a prognostic marker for cardiovascular disease in apparently healthy middle aged subjects,5 6 is significantly higher in small for gestational age (SGA) infants in comparison with appropriate for gestational age (AGA) infants 7. These findings suggest the presence of early vascular damage, possibly due to an inflammatory mechanism.…”