C-Reactive Protein and White Blood Cell Count at Pre / Post Cervical Cerclage Predict Early Preterm Labour

Background and Aim: Preterm birth affects over 15 million infants annually worldwide, with cervical insufficiency being a major contributing factor. This study evaluates CRP and WBC levels in pregnant women undergoing cervical cerclage to predict Early Preterm Birth (EPTB) risk. Methods: A prospective observational study conducted at Bint al-Huda Hospital, Thi-Qar, Iraq, from December 2023 to December 2024. Fifty-four pregnant women with singleton pregnancies and cervical insufficiency (cervical length <25 mm) were enrolled. CRP and WBC levels were measured pre-cerclage and on days 1 and 2 post-cerclage, with follow-up until delivery. Results: Mean participant age was 30.2 years. Cervical length improved from 20.6 mm pre-cerclage to 23.8 mm post-cerclage. Mean gestational age at cerclage was 20.6 weeks, with delivery occurring at a mean of 35.3 weeks. Only 18.5% delivered before 34 weeks, while 81.5% delivered at or beyond 34 weeks. Elevated pre-cerclage CRP and WBC levels were significantly associated with increased EPTB risk. Post-cerclage monitoring identified persistent inflammation correlating with adverse outcomes. Conclusions: CRP and WBC are reliable biomarkers for predicting EPTB in women undergoing cervical cerclage. Elevated pre-cerclage levels indicate higher risk, necessitating close monitoring and early intervention. Post-cerclage trends provide critical insights into inflammatory responses, enabling targeted management to improve maternal and neonatal outcomes. Further research is recommended to refine predictive models and explore therapeutic strategies.