Associate Professor University of Tennessee Health Science Center College of Medicine Germantown, Tennessee, United States
Background: Increased body mass index (BMI) is associated with several adverse pregnancy outcomes. It increases the oxidative stress and subsequently increases the concentrations of pro inflammatory cytokines including interleukin-6 (IL-6) which is a precursor to C-reactive protein production. White adipose tissue is an important site for secretion of IL-6, which can cross the placenta unlike CRP and stimulates neonatal hepatocytes to synthesize and secrete CRP. There are conflicting reports about fetuses of mothers with obesity having increased markers of inflammation in the cord blood including CRP. In neonates, CRP values > 1.0 mg/dl is considered abnormal and may be an indication for a full septic work up and empiric antibiotics administration Objective: We hypothesized that maternal pre-pregnancy BMI would lead to elevated CRP values in healthy newborns. Our aim is to examine the association between pre-pregnancy BMI and the CRP concentration in healthy newborns Design/Methods: From June 2017-June 2019, left over blood samples drawn for jaundice and/or hypoglycemia from clinically healthy newborns in well baby nursery were saved, batched, and evaluated for CRP a week later. These CRP values were not a part of medical records and did not influence the medical management. Infants were divided into 4 cohorts based on maternal pre pregnancy BMI ( < 25, 25-29.9, 30-34.9 and ≥ 35) and only the first CRP values were compared. Family contacted by phone at one week and at one month post discharge to check on the infants’ clinical status Results: A total of 232 infants were enrolled and CRP was evaluated on 95 samples. Median CRP values were not significantly higher in higher BMI cohorts when compared to mothers with normal BMI (Figure 1). Demographics described in Table1. 8 samples had CRP >1 mg/dl and highest CRP is 4.66. Only 2 infants ( < 1%) were admitted to the hospital within 1 week post discharge. 7 infants (3%) were admitted to the hospital within one month follow up for various reasons. None of the infants were septic or bacteremic.
Conclusion(s): Contrary to our hypothesis, the CRP values did not increase with increase in maternal BMI. Slightly elevated CRP values should be carefully evaluated with clinical and other laboratory parameters before considering empiric antibiotics.
.png)