Association between maternal serum C-reactive protein in early pregnancy and spontaneous preterm delivery: a prospective hospital based study in Yangon, Myanmar

Background: Premature birth continues to be a major factor in perinatal illness and death worldwide. Inflammatory markers such as C-reactive protein (CRP) have been proposed as predictive biomarkers for preterm birth, yet their predictive utility remains inconclusive. This study aimed to assess the relationship between maternal serum CRP levels evaluated in advance before 22 weeks of gestation and the happenings of spontaneous preterm delivery. Methods: A prospective study conducted at Central Women’s Hospital, Yangon period between January to December in 2016. A total of 253 pregnant women with singleton pregnancies of less than 22 weeks’ gestation were recruited. Maternal serum CRP was measured at enrollment. Women were followed up until delivery. Exclusion criteria included previous preterm delivery, pre-existing medical conditions, obstetric complications, and later development of systemic infection. Final analysis was conducted on 234 participants. Statistical analysis included chi-square and Fisher's exact test, with significance set at p < 0.05. Results: The overall preterm delivery rate was found to be 3.4% (n = 8). CRP levels > 4 mg/L were observed in 75% of those who delivered preterm. However, when analyzed using a cut-off value of > 6 mg/L, the association between elevated CRP and preterm delivery did not reach statistical significance (p = 0.087). Conclusion: High level of maternal serum CRP levels in early pregnancy not evidenced significant association with spontaneous preterm delivery in this cohort. CRP may not serve as a reliable standalone biomarker for predicting preterm birth, underscoring the need for further large-scale studies incorporating multiple markers.