ASSOCIATION OF PLASMA FIBRINOGEN LEVEL AND C-REACTIVE PROTEIN LEVEL WITH SEVERITY OF PREECLAMPSIA

Background: Preeclampsia is a pregnancy disorder that is a leading cause of maternal and perinatal morbidity and mortality, characterized by elevated blood pressure and proteinuria after 20 weeks of gestation. In preeclampsia there is a shift in the hemostatic balance towards a prothrombotic state together with changes in endothelial function, and C-reactive protein (CRP) is a sensitive inflammatory marker that rises in response to inflammation or tissue injury. Aim: To determine the association of plasma fibrinogen level and C-reactive protein level with the severity of preeclampsia. Patients and Methods: A prospective case-control study was conducted at Al-Khansaa and Al-Batool Teaching Hospitals, Mosul, Iraq, and included 50 pregnant women with preeclampsia in the third trimester (14 mild, 36 severe) and 50 normotensive pregnant women in the third trimester as controls. Plasma fibrinogen and C-reactive protein levels were measured and compared between the groups and subgroups. Results: Plasma fibrinogen level was significantly higher in women with preeclampsia than in normotensive pregnant women (259.74 ± 56.13 vs. 237.04 ± 46.51 mg/dL, P = 0.03) and increased further with disease severity, being higher in severe than in mild preeclampsia (282.44 ± 45.36 vs, 201.35 ± 35.16 mg/dL, P = 0.0001). C-reactive protein was also significantly higher in preeclamptic women than in controls (13.88 ± 6.42 vs. 10.43 ± 6.06 mg/L, P = 0.044) but showed no significant difference between mild and severe preeclampsia (P = 0.271). Fibrinogen correlated positively with systolic blood pressure and mean arterial pressure (P = 0.023 and P = 0.024, respectively) and with the degree of albuminuria (P = 0.0001), while CRP showed no significant correlation with blood pressure parameters or albuminuria. Conclusion: Plasma fibrinogen and C-reactive protein levels are increased in women with preeclampsia compared with normotensive pregnant women, and higher fibrinogen levels are associated with more severe disease, whereas CRP does not distinguish mild from severe preeclampsia. Plasma fibrinogen may therefore serve as a useful adjunct marker for assessing preeclampsia severity.