• Sowmya Krishnamurthy Sri Ramachandra University Porur,Chennai
  • Prabu Kumar Sri Ramachandra University Porur,chennai



Background: C-reactive protein (CRP) is a well-known indicator of inflammation, infection, and stress. Acute hypoxia that develops a short time before birth due to fetal distress may cause an elevation in the hs CRP levels. Hence this study was taken up to compare the hs CRP levels in neonates delivered by different modes of delivery and to determine if there are any changes due to fetal distress

Materials and Methods:  The present study included 34 full term neonates, delivered by vaginal route (10), elective caesarean (12) and emergency caesarean (12) sections in the

Obstetrics Unit of Sri Ramachandra Medical College & Research Institute, Chennai. High sensitive CRP concentrations were measured in the venous cord blood of these neonates and analyzed in Dade Behring RXL Dimension clinical chemistry auto analyzer. Neonatal characteristics like gestational age, birth weight, Apgar scores, length and head circumference were also recorded . Statistical analysis was performed using the SPSS for Windows15.0 statistical program. The mean rank values were calculated and differences between mean values of the groups were analyzed by Kruskal Wallis Test and p values <0.05 were considered to be statistically significant. Pearson correlation analysis was used to determine the relationships between CRP levels and neonatal variables.

Result: Statistically significant difference was observed in hs CRP levels in neonates delivered by different modes. No significant correlation was observed between CRP levels and other neonatal variables

Conclusion: The babies delivered by elective cesarean section had significantly lower levels of hs CRP levels compared to babies delivered by other modes. Fetal distress in emergency cesarean section and vaginal delivery has lead to increased hs CRP levels. Thus increase in hs CRP levels reflects the intensity of stress on baby during delivery in the immediate postnatal period and does not necessarily indicate an infected status.

Key words: hs CRP, delivery, fetal distress


Author Biographies

Sowmya Krishnamurthy, Sri Ramachandra University Porur,Chennai

Department of Biochemistry

Associate Professor

Prabu Kumar, Sri Ramachandra University Porur,chennai

department of Biochemistry,

Assistant professor



1. Rifai N, Ridker PM. High-sensitivity C-reactive protein: a novel and promising marker of coronary heart disease. Clin Chem 2001;47:403–11.
2. Danesh J, Whincup P, Walker M, Lennon L, Thomson A, Appleby P, et al. Low grade inflammation and coronary heart disease: prospective study and updated meta-analyses. BMJ 2000;321:199–204.
3. Ainbender E, Cabatu EE, Guzman DM, Sweet AY. Serum C-reactive protein and problems of newborn infants. The Journal of Pediatrics. 1982;101(3):438-40.
4. Dyck RF, Bingham W, Tan L, Rogers SL. Serum levels of C-reactive protein in neonatal respiratory distress syndrome. Clinical Pediatrics. 1984;23(7):381-3.
5. Ishibashi M, Takemura Y, Ishida H, Watanabe K, Kawai T. C-reactive protein kinetics in newborns: application of a high-sensitivity analytic method in its determination. Clinical Chemistry. 2002;48(7):1103-6.
6. Rifai N, Tracy RP, Ridker PM. Clinical efficacy of an automated highsensitivity C-reactive protein assay. Clin Chem 1999;45:2136–41.
7. Kawamura M, Nishida H. The usefulness of serial C-reactive protein measurement in managing neonatal infection. Acta Paediatr 1995;84:10–3
8. Benitz WE, Han MY, Madan A, Ramachandra P. Serial serum C-reactive protein levels in the diagnosis of neonatal infection. Pediatrics 1998;102: E41.
9. Pourcyrous M, Bada HS, Korones SB, Baselski V, Wong-SP. Significance of serial C-reactive protein responses in neonatal infection and other disorders. Pediatrics 1993;92:431–5.
10. Ng PC. Diagnostic markers of infection in neonates. Archives of Disease in Childhood Fetal and Neonatal Edition. 2004;89(3):F229-35-F-35.
11. Loukovaara M. Leinonen P. Teramo K. Alfthan H. Stenman UH. Andersson S (2004). Fetal hypoxia is associated with elevated cord serum C-reactive protein levels in diabetic pregnancies. Biol. Neonate. 854:237-242.
12. Hofer N, Müller W, Resch B. Non-infectious conditions and gestational age influence Creactive protein values in newborns during the first 3 days of life. Clinical Chemistry and Laboratory Medicine: CCLM / FESCC. 2011;49(2):297-302.
13. Mathai E, Christopher U, Mathai M, Jana AK, Rose D, Bergstrom S. Is C-reactive protein level useful in differentiating infected from uninfected neonates among those at risk of infection? Indian Pediatrics. 2004;41(9):895-900.
14. Chiesa C, Signore F, Assumma M, Buffone E, Tramontozzi P, Osborn JF, et al. Serial measurements of C-reactive protein and interleukin-6 in the immediate postnatal period: reference intervals and analysis of maternal and perinatal confounders. Clinical Chemistry. 2001;47(6):1016-22.
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How to Cite
Krishnamurthy, S., and P. Kumar. “COMPARISON OF HIGH SENSITIVE C-REACTIVE PROTEIN LEVELS IN NEONATES DELIVERED BY DIFFERENT MODES OF DELIVERY”. Asian Journal of Pharmaceutical and Clinical Research, Vol. 7, no. 2, Apr. 2014, pp. 6-8,