Level of High Sensitive C-reactive Protein and Procalcitonin in Pregnant Women with Mild and Severe Preeclampsia

Abstract

Background:In this study, we compare the level of two inflammatory markers, high sensitive C-reactive protein (hs-CRP) and procalcitonin (PCT), in pregnant women with mild and severe preeclampsia (PE) and women with normal pregnancy.Materials and Methods:In this case–control study, normal pregnant women and pregnant women with PE were enrolled. Pregnant women with diagnosed PE were selected as case group and classified into two groups with mild and severe PE. Serum samples for measurement of hs-CRP and PCT were obtained and compared in studied groups.Results:In this study, 50 normal pregnant women and 59 pregnant women with PE, 26 (44.1%) mild, and 33 (55.9%) severe were studied. Mean of hs-CRP and PCT was higher in pregnant women with PE than normal pregnant women (7.71 ± 6.19 vs. 5.44 ± 3.94, P = 0.02 for hs-CRP and 0.05 ± 0.03 vs. 0.04 ± 0.01, P = 0.001 for PCT). Area under curve for hs-CRP and PCT was 0.611 and 0.646, respectively. The optimal cut-off point for hs-CRP was 5.24 with a sensitivity of 62.7% and a specificity of 56%. The optimal cut-off point for PCT was 0.042 with a sensitivity of 71% and a specificity of 54%.Conclusion:The findings of this study indicated that higher level of hs-CRP and PCT in pregnant women with PE than those with normal pregnancy could potentially explain the exaggerated inflammation in PE. Regarding significantly increased level of hs-CRP in severe PE than mild PE, we could suggest that hs-CRP is more appropriate marker for investigating pregnant women with severe PE, and its clinical usefulness is superior to PCT in this regard.

Overview of procalcitonin in pregnancy and in pre-eclampsia

“…In Table 1 we report a summary of the studies that aimed to understand if PCT is a PE marker [49,[52][53][54][55][59][60][61][62][63]. At present, however, there are no plasmatic factors that can be considered PE markers with a predictive value.…”

“…Perhaps for this reason, numerous studies have been carried out during the last 5 years to verify if the PCT could be an ideal candidate for this role. In Table 1 we report a summary of the studies that aimed to understand if PCT is a PE marker [49,[52][53][54][55][59][60][61][62][63]. In general, we can deduce that PCT plasmatic levels are increased in PE and its levels correlate with the severity of the disease, but PCT has no predictive value.…”

The role of interleukins in preeclampsia: A comprehensive review

“…More specifically, there is evidence that inflammatory mechanisms provide the key link between placental ischemia and endothelial dysfunction. In this context, serum markers of systemic inflammation, such as C‐reactive protein and procalcitonin, have been reported to be elevated in PE pregnancies. Thus, it has been hypothesized that impaired regulatory systems fail to adjust the resolution of inflammatory pathways, contributing to an exaggerated immune response .…”

Disruption in the Regulation of Immune Responses in the Placental Subtype of Preeclampsia

“…The role of inflammatory markers with elevated levels in preeclampsia has also been investigated, including the role of procalcitonin (PCT) and C-reactive protein (CRP) ( 45 ). PCT is a precursor of calcitonin and is used as a marker of bacterial infection and resultant systemic inflammation ( 45 , 46 ).…”

“…The role of inflammatory markers with elevated levels in preeclampsia has also been investigated, including the role of procalcitonin (PCT) and C-reactive protein (CRP) ( 45 ). PCT is a precursor of calcitonin and is used as a marker of bacterial infection and resultant systemic inflammation ( 45 , 46 ). The exact role of PCT and CRP in preeclampsia remains controversial, with the literature revealing conflicting accounts of their usefulness in predicting preeclampsia and its severity ( 45 ).…”