MATERNAL SERUM C-REACTIVE PROTEIN CONCENTRATION IN EARLY PREGNANCY AND SUBSEQUENT RISK OF PRETERM DELIVERY

A prospective study was conducted in the department of Obstetrics and Gynaecology, Susheela Tiwari Memorial Hospital, Haldwani, from September 2012 to September 2013. OBJECTIVES: Its aim & objective was to study the relationship between maternal Serum C-Reactive Protein concentration in Early Pregnancy and subsequent Risk of Preterm Delivery. MATERIAL & METHODS: Women eligible for inclusion in the present study were those who initiated prenatal care prior to 20 wks gestation, were 18 years of age or older and planned to carry the pregnancy to term. Women excluded from the study were those with previous history of preterm delivery, pregnancy induced hypertension or those with gestational diabetes mellitus. Of the total 106 women who participated in the study, 6 were excluded (those who experienced an abortion or fetal demise prior to 28 weeks of gestation and those with multi-fetal pregnancies). Thus, a cohort of 100 women remained for analysis. Gestational age was based on the last menstrual period and confirmed by USG conducted prior to 20 weeks gestation. Maternal blood samples were collected at 12-14 weeks gestation. Serum CRP concentrations were measured by an ultra-sensitive competitive immunoassay. We categorized preterm delivery cases according to gestational age at delivery as very preterm delivery (<= 34 weeks gestation) and moderate preterm delivery (between 34 and 37 weeks). RESULTS: We observed increased risk of preterm delivery among women with CRP concentrations >= 7.5 mg/l as compared with women whose concentrations were <2.0 mg/l. We noted little evidence of an association between maternal serum CRP concentrations& moderate preterm delivery. However, elevated CRP concentrations were associated with an increased risk of very preterm delivery. CONCLUSIONS: From this study, we concluded that determination of CRP status using serum collected in early pregnancy served to clarify the temporal relationship between elevated maternal serum CRP concentrations and subsequent risk of preterm delivery i.e., elevated CRP concentration in early pregnancy is associated with an increased risk of Preterm delivery. But there were some limitations of the study as only single measurement of serum CRP was done & the relatively small number of subjects available for subgroup analyses. Keywords: CRP, early pregnancy, preterm delivery. Maternal Serum C-Reactive Protein Concentration in Early Pregnancy and Subsequent Risk of Preterm Delivery.