Evaluation of Phosphorylated Insulin like Growth Factor Binding Protein-1 and Sonographically Measured Cervical Length for Prediction of Preterm Birth in Threatened Preterm Labor: A Clinical Approach

AbstractPurpose:To determine values of combinations of interleukin-6 (IL-6)/cervical native insulin-like growth factor-binding protein-1 (IGFBP-1)/total IGFBP-1 (Premaquick©) in predicting spontaneous deliveries and spontaneous exclusive preterm deliveries in women with threatened preterm labor.Methods:Women with singleton pregnancies between gestation age (GA) of 24 weeks and 36 weeks and 6 days with preterm labor were recruited during a prospective multicenter study. Premaquick© was positive when at least two of three biomarkers were positive. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were estimated for both prediction of spontaneous deliveries and spontaneous exclusive preterm deliveries.Results:Ninety-seven (99.0%) out of 98 women enrolled were analyzed. Based on delivery status 7/14 days post-enrollment of general study population, Premaquick© had a sensitivity of 87.1/85.7%, a specificity of 92.4/96.8%, a PPV of 84.4/93.8% and a NPV of 93.9/92.3% for prediction of spontaneous delivery. Predictive accuracy of Premaquick© test in relation to days of enrollment were: 90.7% (≤7 days) and 92.8% (≤14 days). For women enrolled at GA <35 weeks, Premaquick© had a sensitivity of 100.0/87.5%, a specificity of 94.1/96.9%, a PPV of 70.5/87.5%, a NPV of 100.0/96.9% and an accuracy of 95.0/95.0% for prediction of preterm delivery within 7/14 days of enrollment, respectively. PPV was most significantly different in both groups when outcomes were compared between 2 days and 14 days post-enrollment (P<0.001).Conclusion:This novel triple biomarker model of native and total IGFBP-1 and IL-6 appears to be an accurate test in predicting spontaneous deliveries and spontaneous exclusive preterm deliveries in threatened preterm labor in singleton pregnancies.

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Accuracy of Phosphorylated Insulin-Like Growth Factor Binding Protein-1 in Predicting Preterm Labour

Journal of Biomedical and Clinical Research ◽

10.2478/jbcr-2020-0019 ◽

2020 ◽

Vol 13 (2) ◽

pp. 134-138

Author(s):

Elitsa H. Gyokova ◽

Yordan D. Popov ◽

Yoana G. Ivanova-Yoncheva ◽

Kamelia K. Dimitrova ◽

Klaudia I. Dekova

Keyword(s):

Preterm Birth ◽

Growth Factor ◽

Preterm Labour ◽

Binding Protein ◽

Cervical Length ◽

Morbidity And Mortality ◽

Premature Delivery ◽

Insulin Like Growth Factor ◽

Factor Binding ◽

Clinical Biomarkers

Summary Preterm birth is the most common cause of perinatal morbidity and mortality worldwide. The routine method for predicting premature birth is the measurement of the cervical length. However, to make a better and more precise prognosis, the cervicovaginal fluid (CVF) was widely inspected through many studies. Its content is used nowadays as a diagnostic method for different conditions. One of the clinical biomarkers used to predict preterm labour in the CVF is the phosphorylated insulin-like growth factor binding protein-1 (pIGFBP-1). This study aimed to evaluate the accuracy of pIGFBP-1 as a predictor of preterm labour when used with cervical biometrics. A prospective, cross-sectional study was conducted on pregnant patients, divided into groups: Group A included participants at risk for premature labour, and Group B -women with an uncomplicated pregnancy. All patients underwent a test for pIGFBP-1, followed by a transvaginal measurement of the cervical length. A total of 32 patients were recruited for the study. Their pregnancy outcomes were followed up. In the group of symptomatic patients, the results were positive in 8 patients, and despite the intensive tocolytic therapy given, 5 of them gave preterm birth within 14 days. There were two patients with a cervical length of less than 10 mm. They both had positive results for pIGFBP-1 and gave spontaneous preterm birth within a few hours. The predictive value of pIGFBP-1 in cases with negative results was high. The leading cause for fetal morbidity and mortality in the twenty-first century remains premature delivery. Many investigations are currently carried out, aiming to facilitate preterm labor prediction and quickly estimate a pregnant woman’s ability to carry to time. The patients at highest risk are detected by measuring the cervical length. Newly searched clinical biomarkers such as fetal fibronectin found in the CVF might help predict preterm birth in time.

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