Clinical Significance of High First Trimester C- reactive Protein in Prediction for Development of Gestational Diabetes Mellitus

M. Swadi AL-Thweeni, Saba

	Clinical Significance of High First Trimester C- reactive Protein in Prediction for Development of Gestational Diabetes Mellitus
Kerbala Journal of Medicine
Article 1, Volume 9, Issue 2, 2016, Pages 2599-2606 PDF (0 K)
Author
Saba M. Swadi AL-Thweeni
Abstract
b ackground: GDM is glucose intolerance with onset or first recognition during pregnancy, it has been associated with not only acute increased risk for complications of pregnancy but also long-term disease risks for both mother and baby due to inflammation that plays a key role in the pathogenesis of GDM. The need of a reliable early test to diagnose and predict GDM earlier is important for development of useful intervention therapies that may impact not only on the acute but long-term health outcomes. Objective: We performed this survey to investigate the predictive value of the of first-trimester serum CRP as screening test of gestational diabetes mellitus and, to evaluate the correlation between high CRP and body mass index (BMI). Patients and Methods: A prospective cohort study design was conducted in AL -Qadisia City in Iraq from January 2012 to January 2015. Data for the study was collected from patients attending the department of Obstetrics and Gynaecology ,outpatient and private clinic. It included 110 low risk pregnant women at first trimester(8-13 weeks). Study was included after meeting inclusion and exclusion criteria. Venous blood was screened for plasmatic C reactive protein by CLIA system to measure C reactive protein in values with cut- off point of high level more than 3mg/L , fasting blood sugar by photometric method and in addition to routine antenatal tests. They were followed up to delivery by continue to measure fasting blood sugar between 24-28 week and after 28 week of gestation . Also for assessing of complications (10 women were lost to follow ,so only 100 women were finally available). Results: In total, 100 low risk pregnant women at first trimester with high CRP(>3mgL), (mean+SD 5.33+1.61), 88% of them developed GDM, 53women developed between 24-28week(early GDM, group1),35women developed >28 week(late GDM ,group2),while 12 of them remain normal(group3). CRP was significantly high in group1 comparing to group2 and group3 ( mean+SD 6.383+ 1.439 , p< 0.001). BMI was also significantly high in group1 comparing to group2 and group3 (100% versus14.8%). Maternal and fetal complications were significantly less frequent in women with group1 than group2 (1.88%, 11.32% and 17.14%, 28.57%) (p=0.010, 0.040) respectively. Conclusions: We did find a significant correlation between high maternal serum CRP level at first trimester and subsequent development of gestational diabetes and also, our study showed a significant correlation between pre-pregnancy BMI and CRP in early gestational diabetic women
Keywords
reactive protein; gestational diabetes mellitus; body mass index; Pregnancy

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