Journal
REPRODUCTIVE SCIENCES
Volume 20, Issue 6, Pages 715-722Publisher
SPRINGER HEIDELBERG
DOI: 10.1177/1933719112466302
Keywords
preterm birth; C-reactive protein; prepregnancy body mass index; placentas; chorioamnionitis
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Funding
- National Institute of Child Health and Human Development [R01 HD034543]
- National Institute of Nursing Research (Renewal NIH POUCH) [R01 HD34543]
- March of Dimes Foundation (Perinatal Epidemiological Research Initiative Program) [20-FY98-0697, 20-FY04-37]
- Thrasher Research Foundation [02816-7]
- Centers for Disease Control and Prevention [U01 DP000143-01]
- Institutional T32 grant in Perinatal Epidemiology awarded [T32 HD046377]
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To study the association between maternal C-reactive protein (CRP) and preterm delivery (PTD) pathways, CRP was measured in maternal plasma collected at mid-pregnancy (n = 1310). PTD was subdivided into spontaneous (sPTD) or medically indicated (MI-PTD). Histologic chorioamnionitis (HCA) was determined by placental histopathology (n = 1076). Adjusted CRP levels were elevated for sPTD (5.5 mu g/mL) versus term deliveries (4.8 mu g/mL) and higher in sPTD with HCA (6.3 mu g/mL). After removing HCA, an interaction between body mass index (BMI) and sPTD in relation to CRP was noted. In BMI-stratified models, an association between CRP and sPTD among women with prepregnancy BMI >= 25 (8.9 mu g/mL for sPTD; 7.2 mu g/mL for term) was absent among women with lower BMI. We propose that this remaining association in overweight/obese women suggests that CRP may mark an obesity/inflammation PTD pathway that is distinct from the pathway indicated by HCA.
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