Journal Article

Plasma C-Reactive Protein in Early Pregnancy and Preterm Delivery

Waranuch Pitiphat, Matthew W. Gillman, Kaumudi J. Joshipura, Paige L. Williams, Chester W. Douglass and Janet W. Rich-Edwards

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 162, issue 11, pages 1108-1113
Published in print December 2005 | ISSN: 0002-9262
Published online October 2005 | e-ISSN: 1476-6256 | DOI: http://dx.doi.org/10.1093/aje/kwi323
Plasma C-Reactive Protein in Early Pregnancy and Preterm Delivery

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Systemic maternal infections have been associated with preterm delivery. The authors examined the association of C-reactive protein (CRP), a marker of inflammation, with preterm delivery. This nested case-control study was conducted within Project Viva in Massachusetts between 1999 and 2002. Subjects were 117 women who delivered preterm (<37 weeks' gestation) and 117 controls (term deliveries) matched on age, race/ethnicity, and smoking status. High-sensitivity CRP assays were performed on early-pregnancy (5.3–19.3 weeks' gestation) plasma samples. Odds ratios and 95% confidence intervals were estimated by using conditional logistic regression adjusted for matching factors, gestational age at blood collection, and prepregnancy body mass index. Median concentration of CRP was 3.2 mg/liter in cases versus 2.4 mg/liter in controls. No significant association was found between quartiles of CRP and preterm delivery. However, CRP levels exceeding the threshold defined in the literature were associated with increased risk of preterm delivery (odds ratio = 2.55, 95% confidence interval: 1.05, 6.02 for CRP ≥8 mg/liter). The association was stronger among cases who experienced spontaneous delivery (odds ratio = 4.64, 95% confidence interval: 0.94, 22.96) versus indicated delivery (odds ratio = 1.42, 95% confidence interval: 0.44, 4.61). These findings suggest that very high CRP levels in early pregnancy are associated with preterm delivery.

Keywords: biological markers; C-reactive protein; case-control studies; pregnancy; premature birth; CI, confidence interval; CRP, C-reactive protein; OR, odds ratio

Journal Article.  3927 words.  Illustrated.

Subjects: Public Health and Epidemiology

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