Ates Merve, Calis Pinar, Artiktay A Gokcen, Yilmaz Canan, Hirfanoglu Ibrahim Murat, Erdem Ahmet, Erdem Mehmet
Department of Obstetrics and Gynecology, Gazi University Faculty of Medicine, Besevler, Ankara, 06650, Turkey.
Department of Medical Biochemistry, Gazi University Faculty of Medicine, Ankara, 06560, Turkey.
BMC Pregnancy Childbirth. 2025 Aug 21;25(1):873. doi: 10.1186/s12884-025-07970-w.
C-reactive protein (CRP) and procalcitonin (PCT) levels may be elevated under inflammatory conditions. The aim of this study was to determine the cutoff values for CRP and PCT levels during pregnancy and to evaluate the associations of any elevation with obstetric and neonatal outcomes.
This prospective study was conducted from June 2023 to December 2024. The study included 411 singleton pregnant women aged 18-44 years with no apparent clinical infection. Venous blood samples were collected during the visit for routine antenatal care during all three trimesters. Categorical variables were compared between groups via the chi-square test, and Student's t-test was used to compare normally distributed continuous variables. The area under the ROC curve was used to detect sensitivity and specificity and to set a cutoff. Regression analysis was performed to evaluate the effects of age and BMI on obstetric complications. P values < 0.05 were considered statistically significant.
The mean CRP and PCT levels in the study group were 10.9 ± 16.7 and 0.17 ± 1.8, respectively. ROC curves were used to analyze the ability of CRP and PCT values during pregnancy to predict obstetric complications. A cutoff value of 6.72 mg/L (sensitivity: 67%; specificity: 60%) and 0.0385 (sensitivity: 60%; specificity: 61%) was revealed. The incidence of composite obstetric complications was significantly greater in patients with elevated CRP levels (32.4% vs. 67.6%) (p < 0.001). The incidence of preeclampsia, GHT, neonatal complications and the need for intensive care were significantly greater in patients with CRP levels > 6.72. The incidence of composite obstetric complications was significantly greater in patients with elevated PCT levels (59% vs. 41%) (p < 0.001). Patients with elevated PCT levels had a greater frequency of preterm labor or PPROM, neonatal complications, need for intensive care, and RDS.
Elevated CRP and PCT are associated with increased rates of obstetric and neonatal complications. CRP and PCT, which are inexpensive and available, may be used for screening to predict obstetric and neonatal complications during patient follow-up.
This study was approved by the institutional ethical committee of the Gazi University Faculty of Medicine (Approval No:05.06.2023/479).
在炎症状态下，C反应蛋白（CRP）和降钙素原（PCT）水平可能会升高。本研究的目的是确定孕期CRP和PCT水平的临界值，并评估任何升高与产科和新生儿结局之间的关联。
本前瞻性研究于2023年6月至2024年12月进行。该研究纳入了411名年龄在18 - 44岁之间、无明显临床感染的单胎孕妇。在所有三个孕期的常规产前检查就诊时采集静脉血样本。通过卡方检验比较组间分类变量，使用学生t检验比较正态分布的连续变量。利用ROC曲线下面积检测敏感性和特异性并设定临界值。进行回归分析以评估年龄和BMI对产科并发症的影响。P值<0.05被认为具有统计学意义。
研究组的平均CRP和PCT水平分别为10.9±16.7和0.17±1.8。使用ROC曲线分析孕期CRP和PCT值预测产科并发症的能力。得出临界值分别为6.72mg/L（敏感性：67%；特异性：60%）和0.0385（敏感性：60%；特异性：61%）。CRP水平升高的患者复合产科并发症的发生率显著更高（32.4%对67.6%）（p<0.001）。CRP水平>6.72的患者子痫前期、妊娠期高血压疾病、新生儿并发症及重症监护需求的发生率显著更高。PCT水平升高的患者复合产科并发症的发生率显著更高（59%对41%）（p<0.001）。PCT水平升高的患者早产或未足月胎膜早破、新生儿并发症、重症监护需求及呼吸窘迫综合征的发生率更高。
CRP和PCT升高与产科和新生儿并发症发生率增加相关。CRP和PCT价格低廉且易于获得，可用于筛查以预测患者随访期间的产科和新生儿并发症。
本研究经加齐大学医学院机构伦理委员会批准（批准号：05.06.2023/479）。
