Maternal Diet, C-Reactive Protein, and the Outcome of Pregnancy

Abstract

Objective: To examine the association of high-sensitivity C-reactive protein (hsCRP), a systemic biomarker for the inflammatory process at entry to care, with pregnancy-induced hypertension/preeclampsia, adverse outcomes of pregnancy, and the maternal diet.

Design: Random sample (N = 520) with normal glucose tolerance from a large prospective cohort study of urban, low income, minority gravidae.

Results: During pregnancy, the highest tertile of hsCRP (range, 7.06–137.41 mg/L) was associated with significantly increased risks for early preterm delivery (<34 weeks). However, after stratification by maternal pregravid body mass index (BMI), risk for early preterm delivery <34 weeks (adjusted odds ratios [AOR] = 3.58, 95% confidence interval [CI] = 1.05–12.27), and pregnancy-induced hypertension (AOR = 2.66, 95% CI = 1.03–6.86) including preeclampsia (AOR = 2.72, 95% CI = 1.08–6.85) was shown to be specific to lean women (BMI <25) with high hsCRP. Increased hsCRP was unrelated to risk among overweight and obese gravidae. We found high hsCRP to be associated with diet. After stratification by BMI, dietary differences (higher intakes of protein and cholesterol with a lower intake of carbohydrate and a higher entry dietary glycemic index) were associated with increased hsCRP only among lean gravidae and not among those who were overweight or obese.

Conclusions: High hsCRP is a diet-related biomarker for serious complications and poor outcome in lean women with normal glucose tolerance.

Key words::

• C-reactive protein
• diet
• preeclampsia
• pregnancy
• preterm delivery
• small for gestational age

ACKNOWLEDGMENTS

This work was supported by grants from the National Institute of Child Health and Human Development (HD18269 and HD38329), National Institute of Environmental Health Sciences (ES07437), and National Institute of Diabetes and Digestive and Kidney Diseases (DK 078865). The authors would like to thank Our Lady of Lourdes Hospital and the Osborn Medical Center for access to patients.

Table 1. Entry hsCRP, Maternal Characteristics, and Diet

Table 2. Maternal Entry hsCRP Tertiles and Pregnancy Outcome

Table 3. BMI-Stratified Entry hsCRP Tertiles and Pregnancy Outcome

Table 4. BMI-Stratified hsCRP and Diet during Pregnancy¹

Notes

Conflict of interest: The authors have no conflicts of interest to declare.