Authors’ reply to ‘Is there a role for C-reactive protein during and after labour?’

Establishment of reference values for pregnant women is dependent on the use of strict exclusion criteria. Variability in analytical methods can affect the commutability of reference values between laboratories.


Caroline Joyce, Keelin O’Donoghue

Journal Name
Annals of Clinical Biochemistry
Journal Article
Full Citation

Joyce CM, O'Shea PM, O'Donoghue K. Authors' reply to 'Is there a role for C-reactive protein during and after labour?'. Annals of Clinical Biochemistry. 2021 Nov;58(6):672-673. doi: 10.1177/00045632211020774.

Link to Publication


This article was written in response to a query about the upper reference value (34.8 mg/L) for C-reactive protein (CRP) in healthy women at term pregnancy, quoted by our group in an earlier publication. Our reference value is higher than the upper reference value (19mg/L) established in another study on pregnancy-specific reference ranges for CRP. This difference is most likely due the stricter exclusion criteria used in our study and the use of a different method for CRP analysis in the other study. Our reference values were established in a well-defined group of pregnant women with no evidence of clinical infection or autoimmune disease. Comparison of the two CRP methods used in both studies shows evidence of assay bias. Both studies agree that CRP has poor diagnostic utility during and after labour and suggest that a more suitable biomarker, such as procalcitonin should be evaluated to help identify infection during pregnancy.

Pregnancy Loss Research Group

Pregnancy Loss Research Group, Department of Obstetrics & Gynaecology, University College Cork, Fifth Floor, Cork University Maternity Hospital, Wilton, Cork, T12 YE02, Ireland,