C-reactive protein, interleukin-6 and pre-eclampsia: large-scale evidence from the GenPE case-control study

Scand J Clin Lab Invest. 2020 Sep;80(5):381-387. doi: 10.1080/00365513.2020.1747110. Epub 2020 May 13.


Multiple small studies have suggested that women with pre-eclampsia present elevated levels of C-reactive protein (CRP) and interleukin-6 (IL-6). However, little is known regarding the source of this CRP and IL-6 increase. Therefore, the aim of this study was to evaluate the relationship between CRP and IL-6 levels with pre-eclampsia considering different confounding factors. Using data from a large Colombian case-control study (3,590 cases of pre-eclampsia and 4,564 normotensive controls), CRP and IL-6 levels were measured in 914 cases and 1297 controls. The association between maternal serum levels of CRP and IL-6 with pre-eclampsia risk was evaluated using adjusted logistic regression models. Pre-eclampsia was defined as presence of blood pressure ≥140/90 mmHg and proteinuria ≥300mg/24 h (or ≥1 + dipstick). There was no evidence of association between high levels of CRP and IL-6 with pre-eclampsia after adjusting for the following factors: maternal and gestational age, ethnicity, place and year of recruitment, multiple-pregnancy, socio-economic position, smoking, and presence of infections during pregnancy. The adjusted OR for 1SD increase in log-CRP and log-IL-6 was 0.96 (95%CI 0.85, 1.08) and 1.09 (95%CI 0.97, 1.22), respectively. Although previous reports have suggested an association between high CRP and IL-6 levels with pre-eclampsia, sample size may lack the sufficient power to draw robust conclusions, and this association is likely to be explained by unaccounted biases. Our results, the largest case-control study reported up to date, demonstrate that there is not a causal association between elevated levels of CRP and IL-6 and the presence of pre-eclampsia.

Keywords: C-reactive protein; Colombia; Pre-eclampsia; case-control studies; inflammation; interleukin-6.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Biomarkers / blood
  • Blood Pressure / physiology
  • C-Reactive Protein / metabolism*
  • Case-Control Studies
  • Female
  • Fetus
  • Gestational Age
  • Humans
  • Interleukin-6 / blood*
  • Logistic Models
  • Pre-Eclampsia / blood*
  • Pre-Eclampsia / diagnosis
  • Pregnancy
  • Young Adult


  • Biomarkers
  • IL6 protein, human
  • Interleukin-6
  • C-Reactive Protein