Observational studyBMC pregnancy and childbirth2026
Interaction between maternal CRP levels and diabetes on preterm delivery risk: a retrospective observation study.
Observational study in BMC pregnancy and childbirth, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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15 authors.
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Abstract
backgroundPreterm delivery (PTD) is a major cause of neonatal morbidity and mortality, and maternal C-reactive protein (CRP) may serve as an inflammatory marker linked to its risk, with diabetes potentially influencing this association.
objectivesTo evaluate the association between maternal CRP levels and PTD risk and assess whether diabetes modifies this relationship.
methodsThis retrospective observational study included 3,089 singleton pregnancies with available CRP and covariate data from 2015 to 2022. Maternal serum CRP was measured using immuno-turbidimetry and categorized into tertiles (cut-points at 2.3 mg/L and 4.7 mg/L). Logistic regression models estimated odds ratios (ORs) for PTD, and stratified analyses evaluated interaction by diabetes status.
resultsAmong 3,089 pregnancies, 208 (6.7%) were preterm. CRP concentrations were slightly higher in PTD cases than in term births (3.5 vs. 3.3 mg/L; P = 0.042). Logistic regression showed a positive association between the highest CRP tertile and PTD in both unadjusted (β = 0.28) and adjusted models (β = 0.42). Diabetes significantly modified this association. In stratified analyses, CRP tertiles were not associated with PTD among women without diabetes (T3 vs. T1: OR = 1.16, 95% CI: 0.75-1.78), whereas among women with diabetes, being in the highest CRP tertile was associated with a substantially higher risk of PTD (OR = 2.73, 95% CI: 1.44-5.15).
conclusionElevated maternal CRP levels were associated with higher PTD risk only among women with diabetes, suggesting that inflammation may play a more prominent etiologic role in this subgroup.
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