Evaluation of a bedside test for phosphorylated insulin-like growth factor binding protein-1 in preterm labour.
OBJECTIVE
The objective of this study was to assess the efficacy of a bedside test kit for phosphorylated insulin-like growth factor binding protein-1 (IGFBP-1) in the diagnosis of preterm labour and the prediction of subsequent preterm delivery.


METHODS
We performed a bedside test for IGFBP-1 in 47 women who presented to the delivery suite in suspected preterm labour between 23 and 33 weeks. Tocolysis and steroid therapy were administered in all cases.


RESULTS
Twenty-nine women (61.7%) tested negative and 18 women tested positive (38.3%). There was no statistical significance between the 2 groups except that the test-positive group had a greater median cervical dilatation (2.0 cm) compared to the testnegative group (1.0 cm) (P <0.05). The women who tested positive had a statistically significant longer median duration of hospitalisation, stay in delivery suite and tocolytic therapy (5.0 days, 56.0 hours and 34.5 hours respectively) compared to women who were test-negative (3.0 days, 19.0 hours and 10.0 hours respectively) (P <0.05). In addition, 91.7% of the patients in the IGFBP-1 negative group had a delay of more than 7 days between the onset of contractions and delivery, while only 44.4% of the women in the pIGFBP-1 positive group experienced such a delay.


CONCLUSIONS
These results suggest that there may be a role for cervical IGFBP-1 test in the management of women presenting with suspected preterm labour. It may allow us to focus our efforts on women who are more likely to have a preterm delivery and perhaps allow us to avoid unnecessary treatment and to contain healthcare costs.
Kwek
K
K
Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore. kwekeroo@kkh.com.sg
Khi
C
C
Ting
H S
HS
Yeo
G S
GS
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D018970:Insulin-Like Growth Factor Binding Protein 1 / Q000097:blood* / Q000378:metabolism; D007752:Obstetric Labor, Premature / Q000097:blood* / Q000175:diagnosis*; D010766:Phosphorylation; D019095:Point-of-Care Systems; D011247:Pregnancy
D018970:Insulin-Like Growth Factor Binding Protein 1