Nikbakht Roshan, Moghadam Elham Karimi, Nasirkhani Zeinab
Fertility Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Int J Reprod Biomed. 2020 Mar 29;18(3):157-164. doi: 10.18502/ijrm.v18i3.6710. eCollection 2020 Mar.
A considerable evidence suggests that maternal inflammation dysregulation may play as a risk factor for both maternal and neonatal outcomes. The study's objectives were designed to evaluate the correlation between serum C-reactive protein (CRP) levels, as an inflammation factor, preterm delivery, and small for gestational age (SGA) births.
This prospective cohort study was conducted on 120 singleton pregnant women with gestational age less than 20 wk. Maternal CRP serum concentration was measured before 20 wk gestation. Patients were followed-up until the delivery and final outcomes of pregnancy were recorded in terms of preterm delivery and SGA births. : Serum CRP levels in participants with normal fetuses and SGA births were 4.09 1.35 mg/l and 6.04 3.29 mg/l, respectively (p = 0.19), while in cases of preterm delivery, it was 9.63 5.78 mg/l (p 0.001). By using receiver operating characteristic (ROC) curve, serum CRP levels (cut-off point 5.27 mg/l, area 0.836) had acceptable diagnostic accuracy value in distinguishing preterm delivery (sensitivity (75%), specificity (86.1%), positive predictive value (37.5%), negative predictive value (96.87%), accuracy (85%)) and serum CRP levels (cut-off point 6.67 mg/l, area 0.673) in distinguishing SGA births (sensitivity (50%), specificity (91.2%), positive predictive value (23.07%), and negative predictive value (97.19%), and accuracy (89.16 %)).
Higher maternal serum CRP levels measured early in pregnancy may associate with higher risk of preterm delivery and SGA.
大量证据表明，母体炎症调节异常可能是影响母体和新生儿结局的一个危险因素。本研究旨在评估作为炎症因子的血清C反应蛋白（CRP）水平与早产及小于胎龄（SGA）儿出生之间的相关性。
本前瞻性队列研究对120名单胎妊娠且孕周小于20周的孕妇进行。在妊娠20周前测量母体血清CRP浓度。对患者进行随访直至分娩，并记录妊娠的最终结局，包括早产和SGA儿出生情况。正常胎儿组和SGA儿出生组参与者的血清CRP水平分别为4.09±1.35mg/L和6.04±3.29mg/L（p = 0.19），而早产组为9.63±5.78mg/L（p＜0.001）。通过绘制受试者工作特征（ROC）曲线，血清CRP水平（截断点为5.27mg/L，曲线下面积为0.836）在区分早产方面具有可接受的诊断准确性（敏感性（75%）、特异性（86.1%）、阳性预测值（37.5%）、阴性预测值（96.87%）、准确性（85%））；血清CRP水平（截断点为6.67mg/L，曲线下面积为0.673）在区分SGA儿出生方面（敏感性（50%）、特异性（91.2%）、阳性预测值（23.07%）、阴性预测值（97.19%）、准确性（89.16%））。
妊娠早期测得的母体血清CRP水平较高可能与早产和SGA儿出生的较高风险相关。
