High-sensitivity C-reactive protein in umbilical cord of small-for-gestational-age neonates

Several epidemiological studies reported a significant correlation between low birth weight and cardiovascular disease in adult life. Recent studies showed that an inflammatory response has been associated with the development of atherosclerosis. High-sensitivity C-reactive protein (hs-CRP) has been demonstrated to be a sensitive marker of this inflammatory process giving prognostic information in apparently healthy general population as well as in patients with symptomatic atherosclerosis. We hypothesized that the chronic inflammatory process, involved in the future atherosclerotic injury, could be found during the fetal period.

To compare umbilical cord hs-CRP concentrations between small-for-gestational-age (SGA) and appropriate-for-gestational age (AGA) neonates.

Concentrations of hs-CRP (Dade Boehring) were measured in 35 SGA infants (gestational age: mean +/- SD, 34.6 +/- 3.0 weeks) and in 69 AGA neonates (34.2 +/- 3.4 weeks). Neonates with a history of suspected or proven feto-maternal infection were excluded.

In SGA infants, hs-CRP concentrations were significantly higher than in AGA neonates: median (range); 0.06 mg/l (0.02-5.53) vs. 0.02 mg/l (0.02-0.55); p = 0.003. Concentrations of hs-CRP were higher than the detection limit (0.04 mg/l) in 25 (71.5%) SGA infants and in 28 (40.6%) AGA neonates (p = 0.002).

In SGA infants, hs-CRP concentrations are higher than in AGA neonates suggesting the presence of an inflammatory process in this group of patients during the fetal life. This finding could be involved in the previously reported relationship between low birth weight and cardiovascular disease in adult life.