Usefulness of Phosphorylated Insulin-like Growth Factor Binding Protein-1 for Prediction of Preterm Delivery

Park, Ok Rang; Kim, Ju Kyoung; Chang, Bo Seung; Kim, Hang Jin; Kim, Tae Sang; Park, Il Soo

Abstract

OBJECTIVE
The aim of this study was to evaluate whether the presence of phIGFBP-1 in cervical secretion of patients with symptoms suggestive of preterm labor predicts preterm delivery.
METHODS
Patients who were examined at the Department of Obstetrics and Gynecology, Daegu Fatima hospital between 24 weeks' and 34 weeks' gestation with intact membrane, no prior tocolysis, symptoms suggestive of preterm labor, and cervical dilatation <3 cm were recruited. Cerviacal swab samples were assayed for the presence of phIGFBP-1 by immunoenzymometric assay, with a positive result defined as >or=10 microgram/L. Tocolysis and corticosteroids were used when clinically indicated after specimen collection.
RESULTS
phIGFBP-1 was detected in 21 patients among 50 patients analysis. Compared with patients who had negative results, patients who had positive results for phIGFBP-1 were more likely to deliver before 37 weeks (p<0.001), before 34 weeks (p=0.008) and within 7 days (p<0.001). Sensitivity, specificity, positive predictive value and negative predictive value were 77.3%, 85.7%, 81.0%, and 8.28%. Patients with positive results were also treated more with tocolysis and corticosteroids use than patients with negative results. Gestational age at delivery (p<0.001) and birthweight (p<0.001) were lower for patients with positive results.
CONCLUSION
In a population of patients with symptoms, the presence of phIGFBP-1 in cervical secretions defines a subgroup at increased risk for preterm delivery.