Elevated C-Reactive Protein (CRP) during First-Trimester For Gestational Diabetes Screening
Background: Studies investigating the impact of inflammatory factors on gestational diabetes mellitus (GDM) are extremely sparse. This study aimed to find out the association of inflammation as defined by C-reactive protein (CRP) with gestational diabetes.
Methods: This prospective cohort study, conducted in Patel Hospital Karachi from September 2020 to February 2021, enrolled 172 healthy gravid women at ≤ 10 weeks of pregnancy. A structured proforma was used to record age, education, past medical and obstetric history (parity, number of miscarriages, mode of deliveries, gestational age), blood pressure, height, and weight of all patients. Serum concentration of CRP and levels >1mg/dl was considered high. Oral glucose tolerance test was performed at 24-28 weeks to diagnose GDM. Data was analysed by using SPSS and Chi-squared test was applied to compare the difference between groups with, and without diabetes and p-value ≤ 0.05 was considered significant.
Results: Total 93 patients had raised CRP of which 8(4.6%) developed GDM (p<0.00001). Advanced age (p=0.00042) and weight (p<0.00001) were found to be independent risk factors. It was observed that CRP levels rise with increasing weight (p=0.0095) however, parity and blood pressure had no effect on GDM development. Women who had diabetes had higher BMI (<0.00001) showing that increasing weight was an independent risk factor. The sensitivity and specificity of CRP in detecting GDM was 100% and 48.17%.
Conclusion: Raised C-reactive protein levels in first trimester can lead to subsequent development of hyperglycaemia of pregnancy and thus can be considered as an easy and simple screening test for GDM.
Keywords: Gestational Diabetes Mellitus; C-Reactive Protein; Inflammation; Oral Glucose Tolerance Test.