Serum High-Sensitivity C-Reactive Protein (hs-CRP) Levels in Pregnant Women with Preeclampsia ComparedtoNormotensivePregnantWomen:AProspectiveCohortStudy

Abstract

 This prospective cohort study investigated the role of high-sensitivity C-reactive protein

(hs-CRP) as a biomarker in preeclampsia by comparing serum hs-CRP levels between preeclamptic and normotensive pregnant women, and assessing its association with disease severity and fetomaternal outcomes. Conducted atAIIMS Raipur over 18 months, the study included 92 pregnant women aged 21–40 years with singleton pregnancies between 20 and 40 weeks of gestation. Participants were divided into two groups: preeclamptic (n=46) and normotensive controls (n=46). Results revealed significantly elevated hs-CRP levels in preeclamptic patients (mean 12.36  ±  9.71 mg/L) compared to normotensives (mean 3.54  ±  2.41 mg/L), with 100% of the preeclamptic group showing hs-CRP >3 mg/L. hsCRP levels were higher in those with severe preeclampsia, early-onset disease, and preterm deliveries, although the associations were not always statistically significant. A meaningful difference was noted in preterm versus term preeclampsia, with higher median hs-CRP in preterm cases (p = 0.032). Preeclamptic patients also had significantly more adverse maternal and neonatal outcomes, including increased rates of cesarean deliveries, preterm births, lower APGAR scores, and fetal growth restriction. Among maternal complications, hs-CRP was significantly elevated in those with liver dysfunction and premonitoring symptoms. Although no consistent correlation was found between hs-CRP and NICU admission, non-reassuring NST, or meconium-stained liquor, the study highlights the inflammatory nature of preeclampsia and the potential of hs-CRP as a reliable biomarker. Elevated hs-CRP (>4.4 mg/L) was associated with a 31.67-fold higher risk of preeclampsia. These findings underscore the utility of hs-CRP in early risk stratification, suggesting its relevance not only for predicting disease severity but also for identifying women at risk for future cardiovascular complications.