Association of maternal serum high sensitive C‐reactive protein level with body mass index and severity of pre‐eclampsia at third trimester

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 –40 6/7 ] 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/m 2 ( P  < 0.001). In the study group with BMI ≥ 25 kg/m 2 , only severe pre‐eclamptic patients between 28 °/7 and 33 6/7  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/m 2 at third trimester.