Abstract Body: Introduction:
Pre-eclampsia (PE) and other hypertensive disorders of pregnancy (HDP) constitute serious threats to maternal and fetal well-being. While the definitive cause (or causes) of PE has been sought since the time of Hippocrates, maternal immune dysfunction is one of many hypotheses that remain popular. A key component of the innate immune system, C-reactive protein (CRP), is elevated during pregnancies complicated by PE, but it is typically considered a secondary marker of inflammation initiated by other factors. None the less, genetic variants increasing the expression of CRP have been found associated with PE in multiple populations, suggesting a more primary role.
Methods:
Through a combination of self-report, medical record review and birth certificate information, the Strong Heart Study was able to assemble a dataset of 59 cases and 1080 women without similar indications of PE or gestational hypertension. Genotypes related to two CRP variants (rs1341665 and rs1205) were available and additive/dominant models evaluated using Chi-square and logistic regression methods for association with HDP. A p-value of 0.05 was considered statistically significant.
Results:
Neither variant, nor any of the genetic models showed significant association with HDP using either statistical test. Further analysis adjusting for body mass index or a more stringently defined outcome excluding gestational hypertension was similarly uninformative.
Conclusion:
Although previous investigation has demonstrated association between one of these variants (and other CRP variants unable to be tested in this cohort) in an American Indian population, this analysis was unable to replicate this finding. Possible reasons include difficulty comprehensively ascertaining cases and inclusion of other American Indian populations.