Early pregnancy vaginal fluid phosphorylated insulin‐like growth factor binding protein‐1 predicts preterm delivery. (14th February 2013)

• Record Type: Journal Article
• Authors: Kallioniemi, Hanna; Rahkonen, Leena; Heikinheimo, Oskari; Paavonen, Jorma
• Is Part Of: Prenatal diagnosis. Volume 33:Number 4(2013:Apr.)
• Page Start: 378
• Page End: 383
• Publication Date: 2013-02-14
• Subjects: Prenatal diagnosis -- Periodicals; Fetus -- Diseases -- Diagnosis -- Periodicals; Electronic journals; 618.32075
• DOI: 10.1002/pd.4072
• Languages: English
• ISSNs: 0197-3851

Abstract

ABSTRACT: Objective: We aimed to study vaginal fluid phosphorylated insulin‐like growth factor binding protein‐1 (phIGFBP‐1) testing in early pregnancy to predict spontaneous preterm delivery (PTD). Methods: Vaginal and cervical swab samples were collected from 5180 unselected women during the first‐trimester (mean gestational age 13.1 weeks) ultrasound screening. PhIGFBP‐1 was measured in vaginal and cervical fluid by an immunoenzymometric assay. Concentrations of ≥10 µg/L were considered elevated. The outcome measure was spontaneous PTD at <32 or <37 weeks gestation. Results: The median concentrations of first‐trimester vaginal and cervical phIGFBP‐1 were higher in women with spontaneous PTD at <32 and <37 weeks gestation. When 10 µg/L of phIGFBP‐1 was used as a cut‐off level, the OR in predicting PTD at <32 weeks gestation was 8.6 (95% CI 3.6–20.7) for vaginal samples and 3.6 (95% CI 1.7–7.9) for cervical samples. At <37 weeks gestation, the OR in predicting PTD was 3.0 (95% CI 1.9–3.9) for vaginal samples and 1.9 (95% CI 1.4–2.5) for cervical samples. In multiple logistic regression analysis, both elevated vaginal and cervical fluid phIGFBP‐1 levels were independent predictors of PTD both at <32 and <37 weeks gestation. Conclusion: First‐trimester vaginal phIGFBP‐1 performed better than cervical phIGFBP‐1 in the prediction of spontaneous PTD. © 2013 John Wiley & Sons, Ltd. Abstract : What's already known about this topic? Preterm delivery is a significant obstetric problem and is difficult to predict. Selected biomarkers, for example cervical phosphorylated insulin‐like growth factor binding protein‐1 (phIGFBP‐1), can be used to identify women at high risk for PTD. What does this study add? Women with vaginal phIGFBP‐1 ≥10 µg/L in the first trimester were at high risk for PTD at <32 and <37 weeks gestation. Positive vaginal phIGFBP‐1 test was an independent risk factor for PTD.