C-Reactive Protein for Prediction or Early Detection of Pre-Eclampsia: A Systematic Review

Abstract

<b><i>Objective:</i></b> Pre-eclampsia (PE) is a serious disease of pregnancy and one of the major causes of morbidity and mortality for both the mother and baby. This systematic review aims to detect the role of high-sensitivity C-reactive protein (CRP) in the detection of PE. <b><i>Methods:</i></b> Thirty-four articles published between 2001 and 2019 were included in this review. The articles were extracted from OVID Medline and Embase. The study designs of these articles are randomized controlled, cohort, case-control, and cross-sectional studies evaluating CRP as a marker to predict or early diagnose PE. The quality assessment of these articles is made by the modified Quality Assessment of Diagnostic Accuracy Studies 2 tool. Meta-analysis was not done because of clinical and statistical heterogeneity. <b><i>Results:</i></b> A positive association between CRP levels and the development of PE was confirmed in 18 studies. This positive effect was addressed in patients with normal BMI (<25 kg/m<sup>2</sup>) in 3 studies and in overweight patients in 2 studies. One study addressed this positive association in patients with a BMI ranging between 28 and 31 kg/m<sup>2</sup>. Three studies determined a cutoff level of CRP above which a significant risk of PE development should be suspected. These levels ranged between 7 and 15 mg/L. <b><i>Conclusion:</i></b> CRP is a promising cost-effective biomarker that may be used in the prediction of PE. A CRP level higher than 15 mg/L may suggest initiation of low-dose aspirin in low-risk pregnancies.

Clinical characteristics and outcomes of women with adenomyosis pain during pregnancy: a retrospective cohort study

“…(25)(26)(27)(28) Although CRP cannot be used as a marker for predicting the onset of PE, circulating CRP is reported to be elevated in some groups of women, such as those with periodontal disease or obesity, before the onset of PE. (29)(30)(31) Although the number of cases is limited, considering that the maximum CRP preceded the onset of PE in our cohort and that previous reports show an association with inflammation and the onset of PE, enhanced inflammation at the utero-placental unit may be the key factor to induce the onset of PE in women with adenomyosis pain.…”

Correlation of Blood Lipid and Serum Inflammatory Factor Levels With Hypertensive Disorder Complicating Pregnancy

“…③ Lp-PLA2 promotes the release of inflammatory mediators, collagen deposition and fibroblast proliferation in inflammatory reaction sites, and platelet aggregation, which plays an anti-inflammatory and anti-atherosclerosis role and promotes the progress of HDP (16)(17)(18). As a marker of inflammatory reaction in the body, CRP can activate platelet activity, inhibit platelet activating factor, promote platelet release of arachidonic acid and platelet aggregation, and inhibit the binding of platelet activating factor and neutrophils, which plays a role in regulating inflammatory reaction (19). CRP can not only aggravates the inflammatory reaction, but also reduces the sensitivity of tissue cells to insulin, and play a certain role in lipid metabolism disorder (20).…”

Does Maternal SARS-CoV-2 Infection or SARS-CoV-2 Vaccination Trigger an Inflammatory Response in the Fetus? A Prospective Cohort Study

“…The innate immune system is the first line of defense against infection. Innate immunity recognizes microorganisms or nonmicrobial antigens, like an allergen or a transplanted organ, and can result in an exaggerated inflammatory response [5][6][7][8][9][10][11][12][13][14][15][16]. Interleukin-6 (IL-6) promotes humoral immunity to protect against extracellular pathogens and stimulates the production of acute-phase reactants such as C-reactive protein (CRP) by the liver [8].…”