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

Document Type : Original Article

Authors
Reihane Jannesari
Elham Kazemi
Department of Pathology, Medical Faculty, Hormozgan University of Medical Sciences, Hormozgan, Iran
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.

Keywords

1.
Anderson UD, Olsson MG, Kristensen KH, Škerström B, Hansson SR. Review: Biochemical markers to predict preeclampsia. Placenta 2012;33 Suppl:S42-7.  Back to cited text no. 1
    
2.
Duley L. The global impact of pre-eclampsia and eclampsia. Semin Perinatol 2009;33:130-7.  Back to cited text no. 2
    
3.
Kiondo P, Tumwesigye NM, Wandabwa J, Wamuyu-Maina G, Bimenya GS, Okong P. Adverse neonatal outcomes in women with pre-eclampsia in Mulago Hospital, Kampala, Uganda: A cross-sectional study. Pan Afr Med J 2014;17 Suppl 1:7.  Back to cited text no. 3
    
4.
WHO. WHO Recommendations for Prevention and Treatment of Preeclampsia and Eclampsia. Geneva, Switzerland: WHO Department of Maternal and Child Health; 2011.  Back to cited text no. 4
    
5.
Roberts JM, Gammill HS. Preeclampsia: Recent insights. Hypertension 2005;46:1243-9.  Back to cited text no. 5
    
6.
Redman CW, Sargent IL. Immunology of pre-eclampsia. Am J Reprod Immunol 2010;63:534-43.  Back to cited text no. 6
    
7.
Mihu D, Costin N, Mihu CM, Blaga LD, Pop RB. C-reactive protein, marker for evaluation of systemic inflammatory response in preeclampsia. Rev Med Chir Soc Med Nat Iasi 2008;112:1019-25.  Back to cited text no. 7
    
8.
Ertas IE, Kahyaoglu S, Yilmaz B, Ozel M, Sut N, Guven MA, et al. Association of maternal serum high sensitive C-reactive protein level with body mass index and severity of pre-eclampsia at third trimester. J Obstet Gynaecol Res 2010;36:970-7.  Back to cited text no. 8
    
9.
Khairy A, Fathey H, Abddallah KH, Saber A. C-reactive protein level as an inflammatory marker in patients with preeclampsia. Med J Cairo Univ 2012;80:819-22.  Back to cited text no. 9
    
10.
Deveci K, Sogut E, Evliyaoglu O, Duras N. Pregnancy-associated plasma protein-A and C-reactive protein levels in pre-eclamptic and normotensive pregnant women at third trimester. J Obstet Gynaecol Res 2009;35:94-8.  Back to cited text no. 10
    
11.
Mohaupt MG. C-reactive protein and its role in preeclampsia. Hypertension 2015;65:285-6.  Back to cited text no. 11
    
12.
Meisner M. Update on procalcitonin measurements. Ann Lab Med 2014;34:263-73.  Back to cited text no. 12
    
13.
Schneider HG, Lam QT. Procalcitonin for the clinical laboratory: A review. Pathology 2007;39:383-90.  Back to cited text no. 13
    
14.
Kucukgoz Gulec U, Tuncay Ozgunen F, Baris Guzel A, Buyukkurt S, Seydaoglu G, Ferhat Urunsak I, et al. An analysis of C-reactive protein, procalcitonin, and D-dimer in pre-eclamptic patients. Am J Reprod Immunol 2012;68:331-7.  Back to cited text no. 14
    
15.
Artunc-Ulkumen B, Guvenc Y, Goker A, Gozukara C. Relationship of neutrophil gelatinase-associated lipocalin (NGAL) and procalcitonin levels with the presence and severity of the preeclampsia. J Matern Fetal Neonatal Med 2015;28:1895-900.  Back to cited text no. 15
    
16.
Can M, Sancar E, Harma M, Guven B, Mungan G, Acikgoz S. Inflammatory markers in preeclamptic patients. Clin Chem Lab Med 2011;49:1469-72.  Back to cited text no. 16
    
17.
ACOG Committee on Obstetric Practice. ACOG practice bulletin. Diagnosis and management of preeclampsia and eclampsia. Number 33, January 2002. American College of Obstetricians and Gynecologists. Int J Gynaecol Obstet 2002;77:67-75.  Back to cited text no. 17
    
18.
Hakim J, Senterman MK, Hakim AM. Preeclampsia is a biomarker for vascular disease in both mother and child: The need for a medical alert system. Int J Pediatr 2013;2013:953150.  Back to cited text no. 18
    
19.
Rebelo F, Schlüssel MM, Vaz JS, Franco-Sena AB, Pinto TJ, Bastos FI, et al. C-reactive protein and later preeclampsia: Systematic review and meta-analysis taking into account the weight status. J Hypertens 2013;31:16-26.  Back to cited text no. 19
    
20.
Montagnana M, Lippi G, Albiero A, Scevarolli S, Salvagno GL, Franchi M, et al. Procalcitonin values in preeclamptic women are related to severity of disease. Clin Chem Lab Med 2008;46:1050-1.  Back to cited text no. 20
    
21.
Savvidou MD, Lees CC, Parra M, Hingorani AD, Nicolaides KH. Levels of C-reactive protein in pregnant women who subsequently develop pre-eclampsia. BJOG 2002;109:297-301.  Back to cited text no. 21
    
22.
Kristensen K, Wide-Swensson D, Lindstrom V, Schmidt C, Grubb A, Strevens H. Serum amyloid a protein and C-reactive protein in normal pregnancy and preeclampsia. Gynecol Obstet Invest 2009;67:275-80.  Back to cited text no. 22
    
23.
Stefanovic M, Vukomanovic P, Milosavljevic M, Kutlesic R, Popovic J, Tubic-Pavlovic A. Insulin resistance and C-reactive protein in preeclampsia. Bosn J Basic Med Sci 2009;9:235-8.  Back to cited text no. 23
    
24.
Farzadnia M, Ayatollahi H, Hasan-Zade M, Rahimi HR. A comparative study of serum level of vascular cell adhesion molecule-1 (sVCAM-1), intercellular adhesion molecule-1(ICAM-1) and high sensitive C – Reactive protein (hs-CRP) in normal and Pre-eclamptic pregnancies. Iran J Basic Med Sci 2013;16:689-93.  Back to cited text no. 24
Advanced Biomedical Research
Volume 2017, November
November 2017
Pages 1-5