title: C-reactive protein levels, blood pressure and the risks of gestational hypertensive complications: the Generation R Study.
abstract: OBJECTIVE
  Aim of this study was to investigate the associations of C-reactive protein levels, as marker of low-grade inflammation, with blood pressure development during pregnancy and the risks of gestational hypertensive complications. We also explored the role of maternal BMI in these associations.
  
  
  METHODS
  High-sensitivity C-reactive protein levels were measured in early pregnancy (median 13.2 weeks, 95% range 9.6-17.6) in 5816 mothers participating in a population-based prospective cohort study in the Netherlands. Blood pressure measurements were performed in each trimester. Information about pregnancy-induced hypertension and preeclampsia was retrieved from hospital charts of the women.
  
  
  RESULTS
  Longitudinal analyses showed that C-reactive protein levels were not associated with SBP and DBP patterns throughout pregnancy. Trimester-specific multivariate linear regression models showed that as compared to low C-reactive protein levels (<5.0 mg/l), elevated levels (≥20.0 mg/l) were associated with maternal SBP and DBP. Elevated C-reactive protein levels in early pregnancy were associated with the risks of pregnancy-induced hypertension [odds ratio (OR) 2.78, 95% confidence interval (CI) 1.66-4.66]. After adjustment for maternal BMI, all associations attenuated.
  
  
  CONCLUSIONS
  Our results suggest that first-trimester C-reactive protein levels are associated with SBP and DBP levels throughout pregnancy and with gestational hypertensive complications, but these associations are largely explained by maternal BMI.
authors: The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands.
authors: Layla L
authors: LL
authors: de Jonge
authors: Eric A P
authors: EA
authors: Steegers
authors: Gesina D S
authors: GD
authors: Ernst
authors: Jan
authors: J
authors: Lindemans
authors: Henk
authors: H
authors: Russcher
authors: Albert
authors: A
authors: Hofman
authors: Vincent W V
authors: VW
authors: Jaddoe
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D002097:C-Reactive Protein / Q000032:analysis*; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology; D009426:Netherlands / Q000453:epidemiology; D016017:Odds Ratio; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011446:Prospective Studies; D012306:Risk; D055815:Young Adult
chemical_list: D002097:C-Reactive Protein