ABSTRACT
The present study was performed to evaluate the measurement of C-reactive protein [CRP], maternal age and body mass index in the l trimester of pregnancy and subsequent development of gestational diabetes mellitus [GDM]. The study was conducted on 143 non-diabetic pregnant women at Al-Azhar University Hospitals from January 2008 to April 2009. In the 1St trimester, all women were subjected to complete history and clinical examination with especial emphesis to age and measurement of body mass index [BMI]. CRP was measured with high sensitive immunonephelometric latex-enhanced assay in the 1S1 trimester of pregnancy. Gestational diabetes mellitus was diagnosed with screening glucose challenge test [GCT] with 50-gram 1-hour glucose tolerance test at 24 to 28 weeks [normal<140 mg/dl]. A 100-gram 3-hour glucose tolerance test [GTT] confirms GDM when two or more values are above normal [normal values up to; fasting 95 mg/dl; 1 hour 180 mg/dl; 2 hours 155 mg/dl; 3 hours 140 mg/dl]. In the trimester, 52 women were CRP positive [>6mgTL; group I] and 91 women were CRP negative [<6mg/L; group II]. In group I, 18 women [35%] developed GDM, while in group II, 14 women [15%] developed GDM; the incidence of developing GDM was significantly higher in women with pre-excisting high serum level of CRP in the 1st trimester [p<0.01]. Age of women that developed GDM was significantly higher than those not developed GDM [32.5 +/- 5.2 vs. 23.5 +/- 4.1 years; p<0.05 in group 1 and 31.4 +/- 5.3 vs. 23.9 +/- 4.8 years; p<0.05 in group II]. BMI was significantly higher in women that developed GDM than those not developed GDM [28.2 +/- 5.1 vs. 21.2 +/- 4.3 kg/m2; p<0.05 in group I and 27.7 +/- 6.2 vs. 22.2 +/- 5.3 kg/m2; p<0.05 in group]. Serum level of CRP was positively correlated with ages and BMI [p<0.05]. Logestic regression analysis confirmed that CRP is the most independent predictors for subsequent development of GDM [OR 1.4; 95% CI 1.02 to 1.27; P<0.01]. Elevated serum level of CRP, old age and increased BMI measured in the trimester of pregnancy are pridictive factors for subsequent development of GDM. Logestic regression analysis confirmed that CRP is the most independent predictors for subsequent development of GDM. It's recommended to use CRP in first trimester as a predictor of GDM development in late pregnancy