Elevated C-reactive protein and complement C3 levels are associated with preterm birth: a nested case–control study in Chinese women

Abstract

Background: Currently, there are many studies researched the associations between maternal serum inflammatory indicators (i.e. ferritin, C-reactive protein [CRP], C3 and C4) and preterm birth (PTB). The results, however, are inconsistent. Therefore, the aim of this study was to estimate the relationship between maternal serum inflammatory indicators and PTB in a nested case-control (NCC)study. Methods: A NCC study was conducted by Guangxi Birth Cohort Study which enrolled a total of 6203 pregnant women between 5 0/7 and 34 6/7 weeks of gestational age (wGA) from six cities in China between 2015 and 2016. There were 206women who delivered preterm (< 37 0/7 wGA), and 412 women who delivered term birth, those women were matched by maternal age, birth place, gender of infants, and wGA at blood collection. The inflammatory indicators were quantified by immunoturbidimetric methods. Results: Highest quartile concentrations of all inflammatory indicators were determined versus median. After adjusting for maternal age, high levels of CRP (CRP > 16.60 mg/L) are related to the risk of PTB (OR = 2.16, 95% CI: 1.02-4.56, p = 0.044) in the first trimester. The association of C3 was extremely related to those who delivered PTB (OR = 2.53, 95% CI: 1.14-5.64, p = 0.023) in the first trimester. Moreover, no significant associations were found in C4 (p = 0.079) and ferritin (p = 0.067) between PTB. Conclusions: Elevated concentrations of CRP and C3 in the first trimester were associated with increased risk of PTB. Inflammatory indicators may act a pivotal part in early diagnosis and prognosis of PTB.

Association of Complement-Related Proteins in Subjects With and Without Second Trimester Gestational Diabetes

“…CRP was the greatest predictor of an elevated C3 and, when taken into account together with age and BMI in the regression model, then C3 was no longer significantly elevated, suggesting that it is reflecting the GDM rather than being independently associated with it. Consistent with our data, increased C3 and CRP were associated with preterm delivery in other studies ( 34 , 35 ).…”

MFGE8, ALB, APOB, APOE, SAA1, A2M, and C3 as Novel Biomarkers for Stress Cardiomyopathy

“…C3 is the most abundant complement component in serum, mainly macrophage and liver synthesis, and plays an important role in complementing the classical activation pathway and bypass activation pathway [ 16 ]. C3 increases are common in the early stages of some acute inflammation or infectious diseases [ 17 ].…”

SARS-CoV-2 in Pregnant Women: Consequences of Vertical Transmission

“…Furthermore, earlier literature has demonstrated the role of increased CRP levels in preterm labor and premature rupture of membranes in pregnant women ( Najat Nakishbandy and Barawi, 2014 ). CRP is a nonspecific biomarker of inflammation which contributes for preterm birth ( Huang et al., 2020 ). Furthermore, significantly varied levels of inflammatory biomarker CRP was observed in SARS-CoV-2 affected pregnant as well as postpartum women, inflammation caused by SARS-CoV-2 which may contribute for preterm birth ( Khalil et al., 2020 ; Woodworth et al., 2020 ).…”