Association Between Maternal Serum C-Reactive Protein in Early Pregnancy and Spontaneous Preterm Delivery: A Prospective Hospital-Based Study in Yangon, Myanmar

Background Preterm delivery remains a leading cause of perinatal morbidity and mortality globally. Inflammatory markers such as C-reactive protein (CRP) have been proposed as predictive biomarkers for preterm birth, yet their predictive utility remains inconclusive. This study aimed to evaluate the association between maternal serum CRP levels measured before 22 weeks of gestation and the occurrence of spontaneous preterm delivery. Methods A prospective study was conducted from January to December 2016 at Central Women’s Hospital, Yangon. A total of 253 pregnant women with singleton pregnancies of less than 22 weeks’ gestation were recruited. Maternal serum CRP was measured at enrollment. Women were followed until delivery. Exclusion criteria included pre-existing medical conditions, obstetric complications, and later development of systemic infection. Final analysis was conducted on 234 participants. Statistical analysis included chi-square and Fisher's exact test, with significance set at p < 0.05. Results The overall preterm delivery rate was 3.4% (n = 8). CRP levels > 4 mg/L were observed in 75% of those who delivered preterm. However, when analyzed using a cut-off value of > 6 mg/L, the association between elevated CRP and preterm delivery did not reach statistical significance (p = 0.087). Conclusion Elevated maternal serum CRP levels in early pregnancy were not significantly associated with spontaneous preterm delivery in this cohort. CRP may not serve as a reliable standalone biomarker for predicting preterm birth, underscoring the need for further large-scale studies incorporating multiple markers.