Association of maternal serum high sensitive C-reactive protein level with body mass index and severity of pre-eclampsia at third trimester
Journal of Obstetrics and Gynaecology Research, cilt.36, sa.5, ss.970-977, 2010 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 36 Sayı: 5
- Basım Tarihi: 2010
- Doi Numarası: 10.1111/j.1447-0756.2010.01279.x
- Dergi Adı: Journal of Obstetrics and Gynaecology Research
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.970-977
- Anahtar Kelimeler: adverse outcomes, body mass index, C-reactive protein, severe pre-eclampsia
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Aim: To assess a maternal serum level of high sensitive C-reactive protein (hs-CRP) as a useful clinical parameter in prediction of pre-eclampsia severity and, to evaluate the correlation between hs-CRP and body mass index (BMI). Material & Methods: Using cross-sectional study design, CRP was measured by a high sensitive immunoturbidimetric method between 24 and 40 weeks of gestation in normotensive controls (n = 115), in mild (n = 63) and severe (n = 34) pre-eclamptic patients. The receiver operating characteristic analysis was used to estimate the optimal threshold score of hs-CRP. Results: For disease severity evaluation, a hs-CRP concentration of 9.66 mg/L was determined as cut-off point with 88% sensitivity, 81% specificity, 71% positive predictive value and 92% negative predictive value. When all three groups of patients were adjusted for gestational age [24°/7-27,6/7 28°/7-33, 6/7 34°/7-406/7] and BMI, hs-CRP levels of severe pre-eclamptic patients were significantly higher than mild ones and controls in the study group with BMI < 25 kg/m2 (P < 0.001). In the study group with BMI ≥ 25 kg/m2, only severe pre-eclamptic patients between 28°/7 and 336/7 weeks of gestation had significantly higher hs-CRP levels when compared with control and mild pre-eclamptic group (P < 0.001). When the patients were subgrouped as high (≥9.66 mg/L) and low hs-CRP group (<9.66 mg/L), adverse outcomes for hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome and intrauterine growth-restricted baby were statistically significant higher in high hs-CRP group (P = 0.004 and P < 0.001, respectively). Conclusion: Elevated level of hs-CRP is a useful parameter in the severity of clinical risk of pre-eclampsia in patients with BMI < 25 kg/m2 at third trimester. © 2010 Japan Society of Obstetrics and Gynecology.