Postpartum metabolic syndrome and high-sensitivity C-reactive protein after gestational hypertension and pre-eclampsia

Abstract

Objective: To evaluate the association between metabolic syndrome (MetS) and high-sensitivity C-reactive protein (hsCRP), a biomarker of chronic inflammation and an independent predictor for cardiovascular disease overall and in subgroups of women with/without pre-eclampsia and gestational hypertension (GHT).

Methods: A prospective cohort study was conducted in Nairobi, Kenya. Women with pre-eclampsia or GHT and normotensive women within 12 weeks postpartum underwent physical, anthropometric, fasting lipid profile, plasma glucose, and hsCRP measurements at 6 months postpartum. A generalized linear regression model with Poisson distribution adjusted for body mass index and age was used to estimate the association between elevated hsCRP and MetS overall and stratified by pre-eclampsia or GHT.

Results: In the 171 women included in the study, risk of elevated hsCRP (>3 mg/L) was greater among women with compared to those without MetS (adjusted relative risk [ARR] 1.70, 95% confidence interval [CI] 1.05-2.73, P=0.03) and was statistically significantly higher in the hypertensive (ARR 2.16 95% CI 1.01-4.62, P=0.04) but not in the normotensive (ARR 1.46, 95% CI 0.93-2.28) group.

Conclusion: Increased risk of elevated hsCRP postpartum can guide longitudinal mechanistic and intervention studies to reduce postpartum cardiovascular morbidity in women with MetS, especially after pre-eclampsia or GHT.

Keywords: Cardiovascular; Gestational; High-sensitivity C-reactive protein; Metabolic syndrome; Postpartum; Pre-eclampsia.