The aim of the study was to determine whether high C-reactive protein ( CRP ) concentration during pregnancy is associated with later preeclampsia and whether weight status ( BMI ) is a potential modifier of the relation between CRP and preeclampsia.
Twenty-three studies were included in a systematic literature review and a subset of 18 in a meta-analysis. Weighted mean difference ( WMD ) of CRP in preeclampsia and control groups was the estimator. A quality assessment was carried out using a scale specifically developed for this study.
The pooled estimated CRP between 727 women, who developed preeclampsia and 3538 controls was 2.30 mg/l.
The heterogeneity among studies was high ( I2 = 92.8 ). The WMD was found to be lower in studies comprising preeclampsia and control groups with similar BMI [ WMD = 0.85; I2 = 25.3% ] compared with studies among which BMI was significantly elevated in the preeclampsia group [ 2.01; I2 = 0.0% ], which may explain the high heterogeneity of pooled data.
Meta-regression results confirmed that difference in BMI between groups modifies the association of C-reactive protein and preeclampsia.
High quality studies represented 30%.
The pooled WMD suggest that women with higher levels of C-reactive protein may have an increased risk of developing preeclampsia. This association seems to be modified by confounders, such as BMI. ( Xagena )
Robelo F et al, J Hypertens 2013; 31: 16-26