Variation in C-reactive protein at 1 month post-partum by etiology of preterm birth: selective identification of those at risk for both poor pregnancy outcome and future health complications
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Jeffrey M. Denney
,
Thaddeus P. Waters
Abstract
Objective
To assess post-partum inflammation for patients delivering prior to 34 6/7 weeks by birth etiology.
Methods
This was an observational study of early preterm birth (PTB) occurring between 20 0/7 and 34 6/7 weeks of gestation. Serum C-reactive protein (CRP) levels were measured 1 month post-partum. CRP measurements were compared by birth etiology.
Results
A total of 399 women were analyzed. Distribution of birth etiology was 35% (n = 138) preterm labor (PTL), 28% (n = 115) preterm premature rupture of membranes (pPROM), and 37% (n = 141) indicated preterm birth (IPTB). Serum CRP varied by birth etiology (P = 0.036). Women with pPROM had elevated median CRP levels compared to women with PTL (P = 0.037). IPTB demonstrated elevated CRP levels when compared to PTL (P = 0.019). Pre-eclamptic/eclamptic subjects exhibited increased median CRP levels compared to PTL (P = 0.04).
Conclusion
Post-partum inflammation varies by birth etiology. Such variation may serve as identification of subjects whose future pregnancies and, ultimately, overall health status may benefit from inter-pregnancy interventions aimed at reducing inflammatory-associated risk factors.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: Foundation for the National Institutes of Health; Funder Id: http://dx.doi.org/10.13039/100000009, NIMH 1R03MH074750-01. U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Mental Health; Funder Id: http://dx.doi.org/10.13039/100000025, NIH/NIMH 1 K23-HD-04891501A2. Pennsylvania Department of Health; Funder Id: http://dx.doi.org/10.13039/100004897, ME 410002073.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
Disclosure statement: All of the authors state that they have no financial interests that would be viewed as a potential conflict of interest. Moreover, we report that the data contained in this study has not been presented in any other published manuscript.
References
1. Hamilton BE, Martin JA, Osterman MJ. Births: preliminary data for 2015. Natl Vital Stat Rep 2016;65:3–12.Suche in Google Scholar
2. Webb DA, Mathew L, Culhane J. Lessons learned from the Philadelphia Collaborative Preterm Prevention Project: the prevalence of risk factors and program participation rates among women in the intervention group. BMC Pregnancy Childbirth 2014;14:368.10.1186/s12884-014-0368-0Suche in Google Scholar PubMed PubMed Central
3. Ridker PM. C-reactive protein and the prediction of cardiovascular events among those at intermediate risk: moving an inflammatory hypothesis toward consensus. J Am Coll Cardiol 2007;49:2129–38.10.1016/j.jacc.2007.02.052Suche in Google Scholar PubMed
4. Hermes W, Ket JC, van Pampus MG, Franx A, Veenendaal MV, Kolster C, et al. Biochemical cardiovascular risk factors after hypertensive pregnancy disorders: a systemic review and meta-analysis. Obstet Gynecol Surv 2012;67:793–809.10.1097/OGX.0b013e31827682fcSuche in Google Scholar PubMed
5. Wadhwa P, Culhane JF, Rauh V, Barve SS. Stress and preterm birth: neuroendocrine, immune/inflammatory, and vascular mechanisms. Matern Child Health J 2001;5:119–25.10.1023/A:1011353216619Suche in Google Scholar
6. Yeh ET. High sensitivity C-reactive protein as a risk assessment tool for cardiovascular disease. Clin Cardiol 2005;28:408–12.10.1002/clc.4960280905Suche in Google Scholar PubMed PubMed Central
7. De Meeus JB, Pourrat O, Gombert J, Magnin G. C-reactive protein at the onset of labour and at day 3 post-partum in normal pregnancy. Clin Exp Obstet Gyn 1998;25:9–11.Suche in Google Scholar
8. Keski-Nisula L, Kirkinen P, Ollikainen M, Saarikoski S. C-reactive protein in uncomplicated parturients delivered by cesarean section. Acta Obstet Gynecol Scandin 1997;76:862–7.10.3109/00016349709024366Suche in Google Scholar PubMed
9. Guardino CM, Dunkel Schetter C, Hobel CJ, Gaines LR, Schafer P, Thorp JM, et al. Chronic stress and C-reactive protein in mothers during the first postpartum year. Psychosom Med 2017;79:450–60.10.1097/PSY.0000000000000424Suche in Google Scholar PubMed PubMed Central
10. Street L, Fore M, Hostetter O, Quinn K, Denney J. Deviation from gestational weight gain guidelines in the obese Gravida: an adverse impact on maternal and fetal health. J Reprod Med 2018;63:417–25.Suche in Google Scholar
11. Street L, Denney J. Increased systemic inflammation in the first trimester: a potential set-up for pregnancy complications. Reprod Sci 2016;1(Suppl):T-024.Suche in Google Scholar
12. Fore M, Street L, Quinn K, Denney J. Excess weight gain and increased ASA score in the obese gravida: a burgeoning reflection of poor gestational health. Reprod Sci 2016;23(Suppl.):T-022.Suche in Google Scholar
13. Byron J, Darter D, Denney J, DeVente J, Harrison F, Heine P, et al. Pregnancy medical home program care pathway: postpartum care and the transition to well woman care, February 2015. https://www.communitycarenc.org/media/files/pmh-care-pathway-postpartum-care-and-transition-well-woman-care-final.pdf.Suche in Google Scholar
©2019 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Frontmatter
- Review
- The role of complement in preterm birth and prematurity
- Original Articles – Obstetrics
- Variation in C-reactive protein at 1 month post-partum by etiology of preterm birth: selective identification of those at risk for both poor pregnancy outcome and future health complications
- Procedure related risk of premature delivery and fetal growth reduction following amniocentesis, transcervical and transabdominal chorionic villus sampling: a retrospective study
- Cervical length at 31–34 weeks of gestation: transvaginal vs. transperineal ultrasonographic approach
- The origin of amniotic fluid monocytes/macrophages in women with intra-amniotic inflammation or infection
- Placental elasticity assessment by point shear wave elastography in pregnancies with intrauterine growth restriction
- A 17-years analysis of terminations of pregnancy ≥14 weeks of gestation in a German level 1 perinatal center
- Simulation of an impacted fetal head extraction during cesarean section: description of the creation and evaluation of a new training program
- Academic tweeting in #ObGyn. Where do we stand?
- Original Articles – Fetus
- Fetal heart examination at the time of 13 weeks scan: a 5 years’ prospective study
- Comparison of fetal cardiac functions between small-for-gestational age fetuses and late-onset growth-restricted fetuses
- Original Article – Newborn
- Protocols for early discharging of premature infants: an empirical assessment on safety and savings
- Letter to the Editor
- Maternal blood pressure levels prepartum correlate with neonatal birth weight in preeclampsia
Artikel in diesem Heft
- Frontmatter
- Review
- The role of complement in preterm birth and prematurity
- Original Articles – Obstetrics
- Variation in C-reactive protein at 1 month post-partum by etiology of preterm birth: selective identification of those at risk for both poor pregnancy outcome and future health complications
- Procedure related risk of premature delivery and fetal growth reduction following amniocentesis, transcervical and transabdominal chorionic villus sampling: a retrospective study
- Cervical length at 31–34 weeks of gestation: transvaginal vs. transperineal ultrasonographic approach
- The origin of amniotic fluid monocytes/macrophages in women with intra-amniotic inflammation or infection
- Placental elasticity assessment by point shear wave elastography in pregnancies with intrauterine growth restriction
- A 17-years analysis of terminations of pregnancy ≥14 weeks of gestation in a German level 1 perinatal center
- Simulation of an impacted fetal head extraction during cesarean section: description of the creation and evaluation of a new training program
- Academic tweeting in #ObGyn. Where do we stand?
- Original Articles – Fetus
- Fetal heart examination at the time of 13 weeks scan: a 5 years’ prospective study
- Comparison of fetal cardiac functions between small-for-gestational age fetuses and late-onset growth-restricted fetuses
- Original Article – Newborn
- Protocols for early discharging of premature infants: an empirical assessment on safety and savings
- Letter to the Editor
- Maternal blood pressure levels prepartum correlate with neonatal birth weight in preeclampsia
