title: C-reactive protein and fibrinogen levels as determinants of recurrent preeclampsia: a prospective cohort study.
abstract: OBJECTIVE
  Women with a history of early-onset preeclampsia have an increased risk of recurrent preeclampsia and are more prone to develop future cardiovascular disease. At present, risk factors underlying this association are not well characterized. We investigated whether the risk of recurrent preeclampsia is associated with pre-pregnancy levels of common cardiovascular and inflammatory markers.
  
  
  METHODS
  Reproductive follow-up and cardiovascular parameters were obtained for 150 primiparae with a history of early-onset preeclampsia 6-12 months after their first delivery. Simultaneously, fasting plasma samples were collected and tested for lipids, glucose, C-reactive protein and fibrinogen. The relative contribution of each marker to the recurrence risk of preeclampsia and preterm delivery was estimated by Cox proportional hazard models.
  
  
  RESULTS
  Forty-two women (28%) developed preeclampsia in a next pregnancy. Recurrent preeclampsia was related to elevated pre-pregnancy levels of C-reactive protein and fibrinogen when compared to women who did not develop recurrent disease. We found no associations between recurrent preeclampsia and maternal age, pre-pregnancy BMI, smoking or fasting levels of total cholesterol, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, triglycerides and glucose.
  
  
  CONCLUSIONS
  These observations support a role for inflammation in recurrent hypertensive disorders of pregnancy similar to its contribution to later-life atherosclerosis and risk of cardiovascular disease.
authors.affiliation: aDepartment of Obstetrics, Division Woman and Baby, University Medical Center Utrecht, The Netherlands bAcademic Unit of Human Development and Health, University of Southampton, UK.
authors.forename: Bas B
authors.initials: BB
authors.lastname: van Rijn
authors.forename: Jan H
authors.initials: JH
authors.lastname: Veerbeek
authors.forename: Lenneke C
authors.initials: LC
authors.lastname: Scholtens
authors.forename: Emiel D
authors.initials: ED
authors.lastname: Post Uiterweer
authors.forename: Maria P
authors.initials: MP
authors.lastname: Koster
authors.forename: Louis L
authors.initials: LL
authors.lastname: Peeters
authors.forename: Steven V
authors.initials: SV
authors.lastname: Koenen
authors.forename: Hein W
authors.initials: HW
authors.lastname: Bruinse
authors.forename: Arie
authors.initials: A
authors.lastname: Franx
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000209:etiology; D015331:Cohort Studies; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D018836:Inflammation Mediators / Q000097:blood; D007751:Labor, Induced; D011225:Pre-Eclampsia / Q000097:blood* / Q000209:etiology; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators; D005340:Fibrinogen; D002097:C-Reactive Protein