Association of maternal serum CRP, IL-6, TNF-alpha, homocysteine, folic acid and vitamin B12 levels with the severity of preeclampsia and fetal birth weight.
OBJECTIVE
To assess the levels and clinical significance of high sensitive(hs)-CRP (C-reactive protein), IL-6(interleukin-6), TNF-alpha(tumor necrosis factor-alpha), homocysteine, folic acid and vitamin B12 in normotensive healthy pregnant women, mild and severe preeclamptic patients, and to evaluate the correlations between these markers and the severity of preeclampsia and fetal birth weight.


METHODS
Using a cross-sectional study design, hs-CRP, IL-6, TNF-alpha, homocysteine and vitamin B12 were measured in the third trimester of pregnancy from normotensive healthy women with uncomplicated pregnancies (n = 62), mild (n = 61) and severe (n = 60) preeclamptic patients.


RESULTS
There were statistically significant differences between three groups for hs-CRP (p = 0.012), TNF- alpha (p = 0.046), IL-6 (p = 0.015), homocysteine (p < 0.001) and fetal birth weight (p < 0.001). Fetal birth weights in mild (2477 +/- 746) and severe (2435 +/- 768) preeclamptic patients were significantly lower than controls (3485 +/- 365) (p < 0.001). No significant difference was found between the three groups for folic acid (p = 0.066) and vitamin B12 (p = 0.286). Bonferroni adjusted multiple comparison test showed that the statistical differences with respect to TNF-alpha, IL-6 and homocysteine were mainly created by control and severe preeclampsia groups. Hs-CRP levels still remained higher in severe preeclampsia patients than mild preeclampsia and normotensive patients except for overweight patients in the previous two groups after Bonferroni post hoc adjustment test.


CONCLUSIONS
Elevated maternal serum levels of hs-CRP, TNF- alpha, IL-6 and homocysteine in preeclamptic women correlate with fetal birth weight in the early third trimester.
Guven
Melih A
MA
Department of Obstetrics and Gynecology, Kahramanmaras Sutcu Imam University, Faculty of Medicine, Kahramanmaras, Turkey. melihatahanguven@yahoo.com
Coskun
Ayhan
A
Ertas
Ibrahim Egemen
IE
Aral
Murat
M
Zencirci
Beyazit
B
Oksuz
Hafize
H
D000328:Adult; D015415:Biomarkers / Q000097:blood*; D001724:Birth Weight; D002097:C-Reactive Protein / Q000378:metabolism; D003430:Cross-Sectional Studies; D005260:Female; D005492:Folic Acid / Q000378:metabolism; D006710:Homocysteine / Q000097:blood; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D015850:Interleukin-6 / Q000097:blood; D011225:Pre-Eclampsia / Q000097:blood* / Q000503:physiopathology; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D014805:Vitamin B 12 / Q000097:blood; D055815:Young Adult
D015415:Biomarkers; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D006710:Homocysteine; D002097:C-Reactive Protein; D005492:Folic Acid; D014805:Vitamin B 12