Association of Maternal Serum C- Reactive Protein Levels with Severity of Preeclampsia
AbstractThe aim of this study was to investigate C-reactive protein (CRP) level in preeclampsia (PE) and its association with the severity of the disease. This cross-sectional study included 43 women with mild PE, 43 women with severe PE, and 43 healthy pregnant. They were selected in the third trimester of pregnancy in the Afzalipour Hospital, Kerman, Iran, from March 2006 to March 2007. Mean diastolic pressure and level of proteinuria were used as indicators of the severity of the disease. The results were analyzed by t-test and spearman's rank correlation coefficient. Hemoglobin, aspartate and alanine transaminase, creatinine and urine protein excretion, serum CRP, and alkaline phosphatase were higher in women with PE. There were significant correlations between serum CRP levels and diastolic blood pressure (r = 0.5, P = 0), urinary protein excretion (r = 0.5, P = 0), creatinine (r = 0.2, P = 0.003), spartate transaminase (r = 0.3, P = 0), alanine transaminase (r = 0.2, P = 0.006), and Hemoglobin (r = 0.2, P = 0.001). There were a negative correlation between serum CRP and weight of the new born (r = -0.09, P = 0.01) and gestational age in the time of delivery (r = -0.07, P = 0). We showed higher levels of CRP in women with PE. Elevated serum levels of CRP in PE women are, thus, correlated with severity of disease.
Kumru S, Godekmerdan A, Kutlu S, Ozcan Z. Correlation of maternal serum high-sensitive C-reactive protein levels with biochemical and clinical parameters in preeclampsia. Eur J Obstet Gynecol Reprod Biol 2006; 124(2): 164-7.
Ustun y, Engin-ustun Y, Kamaci M. Association of fibrinogen and C-reactive protein with severity of preeclampsia. Eur J Obstet Gynecol Reprod Biol 2005; 121(2): 154-8.
Creasy RK, Resnick R, Iams JD, editors. Maternal-Fetal Medicine: Principles and Practice. 5th ed. Philadelphia: WB Saunders; 2004.
James DK, Steer PJ, Weiner CP, Gonik B, editors. High Risk Pregnancy Management Options. 3rd ed. Philadelphia:WB Saunders; 2005.
García RG, Celedón J, Sierra-Laguado J, Alarcón MA, Luengas C, Silva F, et al. Raised C-reactive protein and impaired flow-mediated vasodilation precede the development of preeclampsia. Am J Hypertens 2007; 20(1): 98-103.
Braekke K, Holthe MR, Harsem NK, Fagerhol MK, Staff AC. Calprotectin, a marker of inflammation, is elevated in the maternal but not in the fetal circulation in preeclampsia. Am J Obstet Gynecol 2005; 193(1): 227-33.
Teran E, Escudero C, Moya W, Flores M, Vallance P, Lopez-Jaramillo P. Elevated C-reactive protein and proinflammatory cytokines in Andean women with preeclampsia. Int J Gynaecol Obstet 2001; 75(3): 243-9.
ACOG Committee on Obstetric Practice. ACOG practicebulletin. Diagnosis and management of preeclampsia and eclampsia. Number 33, January 2002. American College ofObstetricians and Gynecologists. Int J Gynaecol Obstet 2002; 77(1): 67-75.
Redman CW, Sacks GP, Sargent IL. Preeclampsia: an excessive maternal inflammatory response to pregnancy. Am J Obstet Gynecol 1999; 180(2 Pt 1): 499-506.
Erren M, Reinecke H, Junker R, Fobker M, Schulte H, Schurek JO, et al. Systemic inflammatory parameters in patients with atherosclerosis of the coronary and peripheral arteries. Arterioscler Thromb Vasc Biol 1999; 19(10): 2355-63.
Stam F, van Guldener C, Schalkwijk CG, ter Wee PM, Donker AJ, Stehouwer CD. Impaired renal function is associated with markers of endothelial dysfunction and increased inflammatory activity. Nephrol Dial Transplant 2003; 18(5): 892-8.
Stuveling EM, Hillege HL, Bakker SJ, Gans RO, De Jong PE, De Zeeuw D. C-reactive protein is associated with renal function abnormalities in a non-diabetic population. Kidney Int 2003; 63(2): 654-61.
Naicker T, Khedun SM, Moodley J, Pijnenborg R. Quantitative analysis of trophoblast invasion in preeclampsia. Acta Obstet Gynecol Scand 2003; 82(8): 722-9.
Hwang HS, Kwon JY, Kim MA, Park YW, Kim YH. Maternal serum highly sensitive C-reactive protein in normal pregnancy and pre-eclampsia. Int J Gynaecol Obstet 2007; 98(2): 105-9.