First-trimester maternal serum C-reactive protein as a predictor of third-trimester impaired glucose tolerance.
OBJECTIVE
We evaluated whether first-trimester high-sensitivity C-reactive protein (hsCRP), a suggested marker of pregnancy-associated hyperglycemia, predicts third-trimester impaired glucose tolerance (IGT) in a secondary analysis of a prospective cohort of nondiabetic singletons enrolled at <26 weeks gestation.


METHODS
We measured the association between hsCRP collected at <14 weeks among women classified as IGT (gestational diabetes screening results, 135 to <200 mg/dL) and those among normoglycemic women. Multivariable modeling estimated the association between log hsCRP and IGT, adjusted for maternal body mass index (BMI).


RESULTS
Among 300 women, 13% (39 of 300) had IGT. The hsCRP was positively associated with glucose (P = .005). Compared with normoglycemic women, women with IGT had higher log hsCRP (0.87 ± 0.66 vs 0.67 ± 0.60, P = .04), but the association was not significant in adjusted models (adjusted odds ratio 1.20, 95% confidence interval 0.65-2.21). The hsCRP did not predict third-trimester IGT in this analysis when BMI is considered.


CONCLUSIONS
Early identification of women at risk of IGT remains a priority, but the contribution of maternal BMI appears greater than hsCRP.
Department of Obstetrics and Gynecology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA, USA erica.berggren@gmail.com.
Erica K
EK
Berggren
Department of Obstetrics and Gynecology, University of California, San Diego, San Diego, CA, USA.
Hilary A
HA
Roeder
Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Kim A
KA
Boggess
School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Kevin
K
Moss
School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Steven
S
Offenbacher
Department of Obstetrics and Gynecology, Duke University, Durham, NC, USA.
Emilia
E
Campbell
Department of Obstetrics and Gynecology, Duke University, Durham, NC, USA.
Chad A
CA
Grotegut
D000328:Adult; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis*; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D016640:Diabetes, Gestational / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D015999:Multivariate Analysis; D016017:Odds Ratio; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood*; D011263:Pregnancy Trimester, Third / Q000097:blood*; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult
D015415:Biomarkers; D001786:Blood Glucose; D002097:C-Reactive Protein
early pregnancy predictors; high-sensitivity C-reactive protein; impaired glucose tolerance; maternal serum markers