Objectives: To evaluate the relationship between possibility and timing of development pre-eclampsia (PE) and serum levels of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) to determine the predictability of their early serum levels for development of PE.
Patients & Methods: The study included 150 pregnant women; 75 developed PE (PE group) and 75 women completed their pregnancy free of PE manifestations (Control group). Two blood samples were collected; at the 12th week of gestation age (GA) and at time of development of PE for colorimetric estimation of serum CRP level and ELISA estimation of serum levels of TNF-α and IL-6.
Results: PE patients were significantly more obese and showed higher frequency among nullipara. Thirty-one women developed PE before 20 weeks GA (Early PE) and 44 women developed PE after 20 weeks GA (Late PE). Serum levels of CRP, TNF-α and IL-6 were significantly elevated at time of development of PE compared to control and 12th week levels. Serum CRP levels estimated at the 12th week GA were significantly higher, while serum TNF-α was non-significantly higher in early PE than in late PE. Serum IL-6 estimated at 12th week GA was higher in women developed late PE than those developed early PE. High serum CRP level estimated at the 12th week of gestation showed the highest specificity and positive predictive value with high positive likelihood ratio, while high serum TNF-α showed high sensitivity and high serum IL-6 showed highest NPV and negative likelihood ratio for prediction of PE. Statistical analyses defined high serum CRP estimated at the 12th week GA as the only significant predictor for development of early PE, while high serum IL-6 as the persistently significant predictor for development of PE in general.
Conclusion: High serum levels of CRP and IL-6 estimated at the 12th week GA could predict the possibility of development of PE among pregnant women without previous history of pregnancy-related hypertensive disorders, while only early high serum CRP levels could differentiate cases as early or late PE.
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