Cervical phosphorylated insulin-like growth factor binding protein-1 in prediction of preterm delivery

Abstract

Background: The aim of this study was to evaluate the phosphorylated isoform of insulin-like growth factor binding protein-1 (phIGFBP-1) in endocervical secretions as a predictor of preterm delivery in symptomatic and asymptomatic pregnant women.

Methods: The study included 105 patients between 24 and 34 weeks' gestation with uterine contractions and 73 controls. Ph IGFBP-1 in cervical secretions was assessed in all patients by using a qualitative, immunochromatographic one-step dipstick test. Data analysis included Student's test, Chi-Square, Fisher's exact test and Kruskal Wallis variance analysis.

Results: Preterm birth rate was 19.04% (20/105) in the study group. Of the 25 patients with a positive phIGFBP-1 test, mean gestational age at delivery was 32.8+/-3.8, whereas of the 80 patients with a negative phIGFBP-1 test mean gestational age at delivery was 37.8+/-2.5, in the study group (P<0.05). The sensitivity, specificity, positive predictive value and negative predictive value for phIGFBP-1 in symptomatic patients were 70, 87.05, 56 and 92.5%, respectively, while in asymptomatic patients they were 40, 82.35, 14.28 and 94.91%, respectively.

Conclusions: The phIGFBP-1 in cervical secretions is a potential specific marker for preterm delivery occurring before 37 weeks. Also cervical detection of phIGFBP-1 by immunochromatography is a rapid and easily applicable test that highly predicts preterm delivery.