MATERNAL SERUM C-REACTIVE PROTEIN AS A PREDICTIVE MARKER FOR HYPEREMESIS GRAVIDARUM: A CASE-CONTROL STUDY

Background: Hyperemesis gravidarum is a severe form of nausea and vomiting during pregnancy that leads to considerable maternal morbidity, with mechanisms believed to include systemic inflammation marked by elevated biomarkers such as C-reactive protein (CRP). Patients and Methods: An analytic case-control study was conducted in Baghdad, Iraq, from August 2024 to March 2025, involving 100 first-trimester pregnant women diagnosed with hyperemesis gravidarum and 100 matched controls. Comprehensive demographic, clinical, and laboratory assessments were performed, and women with confounding medical conditions, multiple pregnancies, or recent drug use were excluded. Data analysis included t-tests and ROC analysis to evaluate the diagnostic performance of CRP. Results: Women with hyperemesis gravidarum were significantly younger and more likely to be nulliparous compared to controls (p < 0.001 and p =&thinsp;0.029, respectively). Significantly higher CRP levels (0.75 ± 0.15 mg/dL vs. 0.27 ± 0.12 mg/dL, p =&thinsp;0.003) and pronounced disturbances in sodium, chloride, potassium, and liver enzymes were reported in the case group. ROC analysis identified a CRP cut-off of 0.46 mg/dL, yielding 75% sensitivity and 79.4% specificity for predicting hyperemesis gravidarum (AUC =&thinsp;0.780, p < 0.001). Conclusion: Serum CRP is significantly elevated in first-trimester women with hyperemesis gravidarum and serves as a reliable, accessible marker for diagnosis. A threshold of 0.46 mg/dL demonstrates good sensitivity and specificity, supporting the use of CRP measurement in clinical evaluation and management of hyperemesis gravidarum.