C-Reactive Protein (CRP)

C-reactive protein (CRP) testing is a marker for inflammation. Elevated CRP levels can indicate underlying conditions such as infection, chronic inflammation, or complications like preeclampsia. This article covers the significance of CRP testing in pregnancy, reference ranges, and the potential causes of elevated levels to aid in monitoring and optimizing maternal and fetal outcomes.

CRP Testing

The c-reactive protein (CRP), quantitative test measures the concentration of CRP in the blood.

​CRP is primarily produced by the liver in response to certain signals from the immune system, particularly pro-inflammatory cytokines. These cytokines are released by various cells, including macrophages and adipocytes, in response to tissue damage, infection, or inflammation.

CRP plays a role in the body’s immune response by binding to certain substances released by damaged or inflamed cells. It binds to certain substances released by damaged or inflamed cells, including phosphocholine residues on the surface of bacteria, damaged cell membranes, and nuclear material from dead cells. By binding to these substances, CRP helps to activate the complement system, enhance phagocytosis, and promote inflammation at the site of injury or infection. It is a key compound in the clearance of bacteria and dead cells.

There are two CRP tests: quantitative and high-sensitivity.

Quantitative CRP (qCRP): The qCRP test measures CRP levels in the blood within a broader range. This test is often used to assess moderate to high levels of inflammation, such as those seen in acute infections, autoimmune diseases, or inflammatory conditions like rheumatoid arthritis. It is less sensitive than the high-sensitivity CRP assay and may not detect low levels of CRP associated with lower-grade inflammation.

High-Sensitivity CRP (hs-CRP): The hs-CRP assay is more sensitive than quantitative CRP tests and can measure CRP levels within a narrower range. This test is specifically designed to detect low levels of CRP associated with chronic low-grade inflammation. High sensitivity CRP testing is used as a marker of cardiovascular risk and is often included as part of cardiovascular risk assessment panels. It is more accurate in detecting subtle changes in CRP levels, even in the absence of clinically apparent inflammation.

Quantitative CRP (qCRP)

High-Sensitivity CRP (hs-CRP)

CRP in Pregnancy

​Pregnancy is a state of low-grade to moderate-grade inflammation. In response, c-reactive protein levels are increased in pregnancy. A significant increase is seen from 24 weeks through the first week of postpartum.

​Some elevation is normal and protective in pregnancy.

High CRP in Pregnancy

Elevated CRP has been associated with increased risks of preeclampsia, gestational diabetes, intrauterine infections, and preterm birth.

Elevated CRP levels have been found in preeclamptic women, with a median value of 8.8 and a range of 0.3 to 25.5.
​
CRP >5.5 μg/mL increases the risk of spontaneous preterm labor.

Most Common Causes of High CRP in Pregnancy

• Infections
• Autoimmune Disease
• Tissue Injury/Trauma
• Low DHEA/Estrogen
• Iron Overload/Hemochromatosis
• Liver Disease
• Asthma
• Vitamin D Deficiency
• Overexercising
• Obesity

Low CRP in Pregnancy

​Not considered pathogenic

---

Copyright © 2024 Functional Maternity, all rights reserved.

Medical Disclaimer:
This content is for educational purposes only and is intended for licensed medical professionals. It is based on current research, subject to change, and not intended to diagnose, treat, or prevent any medical condition. This information does not replace consultation with a qualified healthcare provider. Seek professional medical evaluation and treatment from a licensed provider. Use of this information is at your own risk.​

---