C-Reactive Protein and Albumin Ratio as a Predictor of Premature Uterine Contractions in Pregnancy

Abstract

Objective: The objective of this study was to investigate the association between the CRP/Albumin ratio and premature uterine contractions, and to evaluate the potential of CRP as a biomarker for predicting preterm delivery.

Methodology: A prospective case-control study was conducted at the Biochemistry Section of the Diagnostic and Research Laboratory, in collaboration with the Gynecology and Obstetrics Department of Liaquat University of Medical and Health Sciences Hospital, Jamshoro, Pakistan. Peripheral venous blood samples totaling 10 ml were collected in anticoagulant-free test tubes and allowed to clot. Serum was then separated from the samples. The concentration of C-reactive protein (CRP) was measured using a highly sensitive immunoassay test with the Modular Roche Cobas C311. Additionally, serum albumin concentrations were analyzed via photo spectrometry using the same instrument.

Results: The average age of women in the case group was 25.5 ± 4.76 years, while in the control pregnancy group it was 29.35 ± 4.81 years. The majority of women in both groups had parity 1-3, constituting 60.7% and 55.1% in the premature and control groups, respectively. Parity 4-6 was observed in 21.3% of the case group and 25.8% in the control group. The average serum albumin level was insignificantly decreased in the premature group (3.30 ± 0.43 g/dl) compared to the control group (3.42 ± 0.54 g/dl) (p = 0.089). Conversely, the average CRP level was significantly increased in the case group (4.94 ± 3.96 mg/dl) compared to the control group (2.10 ± 2.61 mg/dl) (p = 0.001). The CRP level showed a stronger association with premature contractions, as indicated by the ROC curve area of 0.789.

Conclusion: The CRP/albumin ratio was found to be higher among cases with premature uterine contractions compared to those without, suggesting that an elevated CRP/albumin ratio may serve as a predictor of premature birth, particularly in the context of premature contractions. The association between elevated CRP levels and premature contractions implies a potential link between inflammation and the onset of premature labor.