Gandevani Samira Behboudi, Banaem Lida Moghadam, Mohamadi Bita, Moghadam Narges Aliyan, Asghari Mohammad
J Perinat Med. 2012 Jun 14;40(6):601-5. doi: 10.1515/jpm-2011-0190.
Abstract Objective: The aim of this study was to investigate the association between high-sensitivity C-reactive protein (hs-CRP) serum levels in early pregnancy with the severity of preeclampsia (PE) and birth weight.
A prospective cohort study was conducted in Noor City (in the north of Iran) from February 2008 to March 2009. The maternal serum hs-CRP levels were measured in 778 healthy pregnant women between 14 and 20 weeks of gestation. They were followed up to delivery. The women were divided into three groups according to ACOG criteria: mild and severe PE and normal group.
In total, 63 (8.1%) of the subjects developed PE: 30 (3.9%) mild and 33 (4.2%) severe PE. Mean±SD hs-CRP levels in mild (7.2±2.2 mg/L) and severe (9.4±3.9 mg/L) PE were significantly higher than the normal group (2.5±2.7 mg/L). Mean±SD birth weights in severe (3100±590 g) and mild (3150±742 g) PE were significantly lower than uncomplicated pregnancies (3340±590 g). Multiple and linear logistic regression analysis showed that there were significant relationships between hs-CRP levels in mild (odds ratio, 1.66; 95% confidence interval, 1.43-1.93) and severe PE (odds ratio, 2.35, 95% confidence interval, 1.90-2.92) and with birth weight (P<0.001). The receiver operator characteristic curve showed that hs-CRP >4.5 and >5 mg/dL could predict mild and severe PE, respectively. At this level, sensitivity and specificity for mild PE were 100% and 80.7%, and for severe PE were 93.9% and 75.7%, respectively.
hs-CRP can be useful in identifying pregnant women at risk for PE and low-birth weight infants.
摘要 目的：本研究旨在探讨孕早期高敏C反应蛋白（hs-CRP）血清水平与子痫前期（PE）严重程度及出生体重之间的关联。
2008年2月至2009年3月在伊朗北部的努尔市进行了一项前瞻性队列研究。对778名妊娠14至20周的健康孕妇测定其母血清hs-CRP水平。对她们进行随访直至分娩。根据美国妇产科医师学会（ACOG）标准将这些妇女分为三组：轻度和重度PE组以及正常组。
总共63名（8.1%）受试者发生了PE：30名（3.9%）为轻度，33名（4.2%）为重度PE。轻度（7.2±2.2mg/L）和重度（9.4±3.9mg/L）PE组的hs-CRP平均水平显著高于正常组（2.5±2.7mg/L）。重度（3100±590g）和轻度（3150±742g）PE组的出生体重平均水平显著低于无并发症妊娠组（3340±590g）。多因素线性逻辑回归分析显示，轻度（比值比，1.66；95%置信区间，1.43 - 1.93）和重度PE组（比值比，2.35，95%置信区间，1.90 - 2.92）的hs-CRP水平与出生体重之间存在显著关系（P<0.001）。受试者工作特征曲线显示，hs-CRP>4.5mg/dL和>5mg/dL可分别预测轻度和重度PE。在此水平下，轻度PE的敏感性和特异性分别为100%和80.7%，重度PE的敏感性和特异性分别为93.9%和75.7%。
hs-CRP有助于识别有PE风险的孕妇和低出生体重婴儿。
