Biochemical markers predicting pre-term delivery in symptomatic patients: phosphorylated insulin-like growth factor binding protein-1 and fetal fibronectin

Abstract

The aim of this study was to evaluate the efficacy of the phosphorylated insulin-like growth factor-binding protein (phIGFBP-1) and of the fetal fibronectin test (fFN) in predicting pre-term delivery in symptomatic women. We included 210 symptomatic women at 24-34 weeks' gestation, who underwent the phIGFBP-1 and fFN test. We analyzed the prevalence of pre-term delivery in these patients within 7 days upon admission, before the 34th and the 37th weeks' gestation. The 3.8% of women delivered within 7 days upon the admission, the 7.6% before 34 weeks and the 16.2% before 37 weeks' gestation. The phIGFBP-1 and fFN test had a high specificity and a high negative predictive value in predicting pre-term delivery within 7 days, before 34 and before 37 weeks' gestation. The logistic regression of phIGFBP-1 was statistically significant in predicting pre-term delivery with an odds ratio of 10.08 <34 weeks' gestation. The multivariate analysis showed that the phIGFBP test had a higher OR <34 weeks' gestation (p < 0.001) and that the two variables were independent and useful in combination to predict pre-term delivery (<37 weeks' gestation). The phIGFBP-1 test may be better that the fFN test in predicting pre-term delivery before 34 weeks' gestation.