Study of the Correlation between Raised C-reactive Protein Levels in Pregnancy and Feto-maternal Outcome

A BSTRACT Background: Pregnancy induces systemic physiological changes, including immune modulation. C-reactive protein (CRP), an inflammatory marker, has emerged as a potential early predictor of adverse pregnancy outcomes. Elevated CRP levels may indicate subclinical inflammation that precedes complications affecting both mother and fetus. Objective: To evaluate the correlation between maternal mid-pregnancy CRP levels and feto-maternal outcomes, including labor complications, neonatal adaptation, and delivery methods. Materials and Methods: A prospective observational study was conducted at a tertiary care hospital, over one and a half years (September 2023 to March 2025). A total of 220 antenatal women between 22 and 28 weeks of gestation were enrolled and categorized into two groups: those with adverse outcomes and those without. High-sensitivity CRP levels were measured, and maternal, fetal, and labor parameters were monitored. Statistical analysis included Chi-square and t -tests, with significance set at P < 0.05. Results: CRP levels >6 mg/L were found in 41.8% of participants. Elevated CRP was significantly associated with preterm delivery ( P = 0.001) and improved APGAR scores at 1 minute ( P = 0.011) and 5 minutes ( P = 0.012). Contrary to expectations, lower CRP levels were significantly associated with a higher incidence of PPROM ( P = 0.044). No significant associations were found between CRP levels and mode of delivery ( P = 0.750), NICU admission ( P = 0.598), or gestational diabetes mellitus ( P = 0.609). Conclusion: Mid-pregnancy maternal CRP levels show notable links to adverse outcomes like preterm birth and neonatal issues. Despite some surprising associations, CRP holds promise as a low-cost antenatal biomarker, warranting further investigation across populations.