Association of high-sensitivity C-reactive protein serum levels in
early pregnancy with the severity of preeclampsia and fetal birth
weight
Gandevani SB, Banaem LM, Mohamadi B, Moghadam NA, Asghari M
Journal of Perinatal Medicine 1-5 (2012)

Abstract
Objective:
The aim of this study was to investigate the association between high-
sensitivity C-reactive protein (hs-CRP) serum levels in early
pregnancy with the severity of preeclampsia (PE) and birth weight.
Study design:
A prospective cohort study was conducted in Noor City (in the north of
Iran) from February 2008 to March 2009.
The maternal serum hs-CRP levels were measured in 778 healthy pregnant
women between 14 and 20 weeks of gestation. They were followed up to
delivery.
The women were divided into three groups according to ACOG criteria:
mild and severe PE and normal group.
Results:
In total, 63 (8.1%) of the subjects developed PE: 30 (3.9%) mild and
33 (4.2%) severe PE.
Mean±SD hs-CRP levels in mild (7.2±2.2 mg/L) and severe (9.4±3.9 mg/L)
PE were significantly higher than the normal group (2.5±2.7 mg/L).
Mean±SD birth weights in severe (3100±590 g) and mild (3150±742 g) PE
were significantly lower than uncomplicated pregnancies (3340±590 g).
Multiple and linear logistic regression analysis showed that there
were significant relationships between hs-CRP levels in mild (odds
ratio, 1.66; 95% confidence interval, 1.43-1.93) and severe PE (odds
ratio, 2.35, 95% confidence interval, 1.90-2.92) and with birth weight
(P<0.001).
The receiver operator characteristic curve showed that hs-CRP>4.5
and>5 mg/dL could predict mild and severe PE, respectively.
At this level, sensitivity and specificity for mild PE were 100% and
80.7%, and for severe PE were 93.9% and 75.7%, respectively.
Conclusion:
hs-CRP can be useful in identifying pregnant women at risk for PE and
low-birth weight infants.

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Association of ferritin and lipids with C-reactive protein.
Am J Cardiol. 2004 Mar 1;93(5):559-62.
Mainous AG 3rd, Wells BJ, Everett CJ, Gill JM, King DE.
Department of Family Medicine, Medical University of South Carolina,
Charleston, South Carolina 29425, USA. mainouag@musc.edu

C-reactive protein (CRP) and lipids (e.g., low-density lipoprotein
[LDL]) are
both markers of cardiovascular disease risk, yet they are not highly
correlated. Oxidative stress of lipids induced by iron may play a role
in
vascular inflammation, as indicated by CRP. The purpose of this study
was to
examine, in a representative sample of United States adults, the
relation
between ferritin, lipids, and CRP. We analyzed data on adults (aged >
or =25
years) in the National Health and Nutrition Examination Survey III, a
national
public-use data set collected between 1988 and 1994. Ferritin, total
cholesterol, LDL, high-density lipoprotein, and ferritin-lipid
combinations
were analyzed in relation to CRP in age-, gender-, and race-adjusted
models as
well as models with other potential confounding variables. In adjusted
models,
neither elevated ferritin (odds ratio [OR] 1.11, 95% confidence
interval [CI]
0.94 to 1.32) nor elevated LDL was significantly associated with
elevated CRP
(OR 1.03, 95% CI 0.79 to 1.33). Patients with elevated ferritin and
elevated
LDL were more likely to have elevated CRP (OR 1.68; 95% CI 1.06 to
2.68).
Patients with elevated ferritin and low high-density lipoprotein were
also more
likely to have elevated CRP (OR 1.71; 95% CI 1.28 to 2.27). These
results
suggest that both iron and lipids induce inflammation. Future research
needs to
focus on preventive medicine to decrease iron in patients with
elevated lipids.

PMID: 14996579

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High Levels of Iron Increase Risk of Stillbirth

Doctors in Sweden have found that a high level of hemoglobin in early
pregnancy may increase the risk of stillbirth by up to four times,
compared with women who have lower levels of iron in their blood. The
research team from Stockholm's Karolinska Institutet reviewed more
than 700 women who had a stillbirth between 1987 and 1996 and compared
them with the same number of live births.

They found that women with hemoglobin levels of 146g/L or higher at
their first antenatal appointment were nearly twice as likely as women
with lower hemoglobin to have a stillbirth.

They also found that when they excluded stillbirths following pre-
eclampsia or eclampsia, or where the baby was malformed, the link
between hemoglobin levels and stillbirth was stronger still.

When they looked at stillbirths which had occurred after a premature
labour the risk was almost three times greater for those with higher
hemoglobin.

In cases where the stillborn baby was very small the risk was more
than four times higher.

The doctors took into account other factors which may influence
stillbirth such as smoking and maternal age and socio-economic group.

The Swedish research, published in the Journal of the American Medical
Association, also found that that a large decrease in hemoglobin in
pregnancy "tended to be protective" and that anemia did not seem to
have any link with stillbirth.

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