Aim: To assess a maternal serum level of high sensitive C‐reactive protein (hs‐CRP) as a useful clinical parameter in prediction of pre‐eclampsia severity and, to evaluate the correlation between hs‐CRP and body mass index (BMI).
Material & Methods: Using cross‐sectional study design, CRP was measured by a high sensitive immunoturbidimetric method between 24 and 40 weeks of gestation in normotensive controls (n = 115), in mild (n = 63) and severe (n = 34) pre‐eclamptic patients. The receiver operating characteristic analysis was used to estimate the optimal threshold score of hs‐CRP.
Results: For disease severity evaluation, a hs‐CRP concentration of 9.66 mg/L was determined as cut‐off point with 88% sensitivity, 81% specificity, 71% positive predictive value and 92% negative predictive value. When all three groups of patients were adjusted for gestational age [24°/7–27,6/7 28°/7–33,6/7 34°/7–406/7] and BMI, hs‐CRP levels of severe pre‐eclamptic patients were significantly higher than mild ones and controls in the study group with BMI < 25 kg/m2 (P < 0.001). In the study group with BMI ≥ 25 kg/m2, only severe pre‐eclamptic patients between 28°/7 and 336/7 weeks of gestation had significantly higher hs‐CRP levels when compared with control and mild pre‐eclamptic group (P < 0.001). When the patients were subgrouped as high (≥9.66 mg/L) and low hs‐CRP group (<9.66 mg/L), adverse outcomes for hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome and intrauterine growth‐restricted baby were statistically significant higher in high hs‐CRP group (P = 0.004 and P < 0.001, respectively).
Conclusion: Elevated level of hs‐CRP is a useful parameter in the severity of clinical risk of pre‐eclampsia in patients with BMI < 25 kg/m2 at third trimester.