Evaluation of the diagnostic value of the first-trimester maternal serum high-sensitivity C-reactive protein level for prediction of pre-eclampsia

摘要

Aim: The purpose of the present study was to evaluate the diagnostic value of maternal serum high-sensitivity C-reactive protein (hs-CRP) measurement during the first trimester of pregnancy for predicting pre-eclampsia. Material and Methods: A prospective cohort study was performed on 394 pregnant women who were at the gestational age of 8-13 weeks. In all women, serum hs-CRP was measured by latex agglutination test. The women were then monitored to delivery.We compared the hs-CRP of the two groups, those with and without pre-eclampsia. We used the receiver-operator curve for finding the optimum cut-off points. Results: Out of 394 women, 42 cases (10.7%) were complicated by pre-eclampsia, of whom 23 women (56.1%) had severe pre-eclampsia. Mean serum hs-CRP of the pre-eclamptic group was higher than that of the normotensive group (7.06 ± 2.6 mg/L vs 3.6 ± 2.3 mg/L, P = 0.001). The receiver-operator curve showed a significant difference between the under-curve zone for the hs-CRP level with the reference line. Serum hs-CRP of 4 mg/L showed sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy as 78.1%, 72.1%, 25%, 96.5% and 72.8%, respectively. Hs-CRP of more than 7 mg/L was found in 26 (61.9%) cases of pre-eclampsia and 22 (6.25%) normotensive pregnancies, which showed a significant difference (P = 0.001, relative risk = 12.1, 95% confidence interval: 6.91-21.15). Hs-CRP of more than 7 mg/L was found in 17 (73.91%) cases of severe pre-eclampsia and 22 (6.25%) normotensive pregnancies, which showed a significant difference (P = 0.001, relative risk = 9.35, 95% confidence interval: 4.48-19.52). Conclusion: Hs-CRP measurements during the first trimester of pregnancy are helpful in predicting pre-eclampsia.