Prenatal Inflammation and Perinatal Outcomes

Summary

Preventing poor perinatal outcomes is the goal of all prenatal care, yet just who will go on to develop preeclampsia or have a growth-restricted baby is notoriously difficult to predict. A growing body of evidence suggests inflammatory markers can help predict poor outcomes, even prior to, and beyond, the current pregnancy. Our project will measure the response of one robust inflammatory marker, C-reactive protein (CRP), to a safe immune provocation recommended for all pregnant women (the seasonal influenza vaccine), and to find out whether CRP response is associated with increased risk for gestational hypertension, preeclampsia, preterm delivery, or birth weight. This work will help inform whether inflammatory markers should become part of routine prenatal care.

Timeline

Start

2015-10

Primary completion

2019-12

Completion

2020-08

Publications

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• Background Morales E, Guerra S, Garcia-Esteban R, Guxens M, Alvarez-Pedrerol M, Bustamante M, Estivill X, Anto JM, Sunyer J. Maternal C-reactive protein levels in pregnancy are associated with wheezing and lower respiratory tract infections in the offspring. Am J Obstet Gynecol. 2011 Feb;204(2):164.e1-9. doi: 10.1016/j.ajog.2010.08.056. Epub 2010 Oct 25.
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• Background Ruma M, Boggess K, Moss K, Jared H, Murtha A, Beck J, Offenbacher S. Maternal periodontal disease, systemic inflammation, and risk for preeclampsia. Am J Obstet Gynecol. 2008 Apr;198(4):389.e1-5. doi: 10.1016/j.ajog.2007.12.002. Epub 2008 Mar 4.
• Background Spicer J, Werner E, Zhao Y, Choi CW, Lopez-Pintado S, Feng T, Altemus M, Gyamfi C, Monk C. Ambulatory assessments of psychological and peripheral stress-markers predict birth outcomes in teen pregnancy. J Psychosom Res. 2013 Oct;75(4):305-13. doi: 10.1016/j.jpsychores.2013.07.001. Epub 2013 Aug 13.
• Background Teran E, Escudero C, Moya W, Flores M, Vallance P, Lopez-Jaramillo P. Elevated C-reactive protein and pro-inflammatory cytokines in Andean women with pre-eclampsia. Int J Gynaecol Obstet. 2001 Dec;75(3):243-9. doi: 10.1016/s0020-7292(01)00499-4.
• Background Tjoa ML, van Vugt JM, Go AT, Blankenstein MA, Oudejans CB, van Wijk IJ. Elevated C-reactive protein levels during first trimester of pregnancy are indicative of preeclampsia and intrauterine growth restriction. J Reprod Immunol. 2003 Jun;59(1):29-37. doi: 10.1016/s0165-0378(02)00085-2.
• Background Ustun Y, Engin-Ustun Y, Kamaci M. Association of fibrinogen and C-reactive protein with severity of preeclampsia. Eur J Obstet Gynecol Reprod Biol. 2005 Aug 1;121(2):154-8. doi: 10.1016/j.ejogrb.2004.12.009.
• Background von Versen-Hoeynck FM, Hubel CA, Gallaher MJ, Gammill HS, Powers RW. Plasma levels of inflammatory markers neopterin, sialic acid, and C-reactive protein in pregnancy and preeclampsia. Am J Hypertens. 2009 Jun;22(6):687-92. doi: 10.1038/ajh.2009.54. Epub 2009 Mar 12.
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• Results Qiu C, Luthy DA, Zhang C, Walsh SW, Leisenring WM, Williams MA. A prospective study of maternal serum C-reactive protein concentrations and risk of preeclampsia. Am J Hypertens. 2004 Feb;17(2):154-60. doi: 10.1016/j.amjhyper.2003.09.011.

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Indications