Abstract
We aimed to assess the accuracy of cervical phosphorylated insulin-like growth factor binding protein-1 (phIGFBP-1) test alone or in combination with cervical length (CL), to predict preterm birth (PTB) in symptomatic women. We performed a prospective cohort study from 2012 to 2015 including singleton pregnancies with symptoms of preterm labor, intact membranes and CL < 25 mm at 24–34 weeks of gestation. Studied outcome were spontaneous delivery within 7 and 14 days of testing and spontaneous PTB at <34 and <37 weeks of gestation. Among 180 women, 21 (11.7%) had a positive phIGFBP-1 test. Spontaneous PTB occurred within 7 days, 14 days of testing and before 34 weeks and 37 weeks in 7.8%, 10.6%, 12.9% and 28.8%, respectively. The phIGFBP-1 test had a low predictive performance for all studied outcomes varying for positive likelihood ratios (2.8 to 3.4) and negative likelihood ratios (0.8). Combining phIGFBP-1 and CL did not increase its predictive ability. After adjustment, positive phIGFBP-1 test was no more independently associated with a delivery within 7 days (p = 0.55), unlike CL < 15 mm (p = 0.04). In conclusion, phIGFBP-1 test alone or in combination with CL has a low predictive accuracy to predict PTB in symptomatic women.
Highlights
Preterm birth, defined as the birth of a child before 37 weeks of gestation, is one of the most important determinants of neonatal morbidity and mortality
The objective of our study was to evaluate the predictive accuracy of phIGFBP-1 for spontaneous preterm births (PTB) in a large prospective study of singleton pregnancies with symptoms of preterm labor and a short cervical length, and to compare it with the use of cervical length measurement alone or contingently
Women admitted with symptoms of preterm labor had first a transvaginal sonographic measurement of cervical length according to standard protocol[8]
Summary
Preterm birth, defined as the birth of a child before 37 weeks of gestation, is one of the most important determinants of neonatal morbidity and mortality. Reliable prediction of PTB could allow interventions to delay birth in patients with true preterm labor and avoid the use of unnecessary and costly interventions such as hospitalization in patients with false preterm labor. One of these tests is the Actim Partus test (cervical phosphorylated insulin like growth factor binding protein-1 (phIGFBP-1)). The objective of our study was to evaluate the predictive accuracy of phIGFBP-1 for spontaneous PTB in a large prospective study of singleton pregnancies with symptoms of preterm labor and a short cervical length, and to compare it with the use of cervical length measurement alone or contingently
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