C-reactive protein levels at pre-/post-indicated cervical cerclage predict very preterm birth

Aims: To investigate the relation between serum levels of C-reactive protein (CRP) at pre-/post-cerclage points and preterm birth at < 33 weeks of gestation in women with indicated cervical cerclage (CC). Methods: Fifty-eight women with CC indicated for a short or soft cervix, but no visible or protruding fetal membranes into the vagina, between 17 and 26 weeks of gestation, were reviewed. Serum CRP levels were examined three times: just before cerclage, and on day 1 and day 2 post-cerclage. Results: Serum CRP levels on day 1 and day 2, but not just before cerclage, predicted the occurrence of very preterm birth. In women with cervical dilatation of < 3.0 cm, serum CRP levels on post-cerclage day 1 were associated with the increase of very preterm birth [CRP >= 1.5 mg/dL vs. < 1.5 mg/dL: 4/5 (80%) vs. 8/31 (26%), P=0.033]. In women with cervical dilatation of < 3.0 cm, serum CRP >= 3.0 mg/dL on post-cerclage day 2 was also associated with the increase of very preterm birth. Conclusion: In women with indicated CC between 17 and 26 weeks of gestation, increased levels of serum CRP on post-cerclage day 1 or 2 might be ominous signs for very preterm birth.