Cervical phIGFBP-1 in the evaluation of the risk of preterm delivery.
BACKGROUND
To evaluate the accuracy of the decidual phosphorylated isoform of insulin-like growth factor binding protein-1 in endocervical secretions to predict premature delivery in symptomatic and asymptomatic pregnant women.


METHODS
The study included 332 pregnant women: 109 symptomatic patients (study group) and 223 asymptomatic women (control group). For all women, qualitative and quantitative assessment of the decidual phosphorylated isoform of insulin-like growth factor binding protein-1 in endocervical secretions was carried out, but the quantitative assay was finally performed in 282 of 332. Student's test, the chi2 test, and Fisher's exact test were used as appropriate.


RESULTS
The phosphorylated insulin-like growth factor binding protein-1 qualitative test was positive in 35 of 301 women (11.6%) and 11 (31.4%) of them delivered before 37 weeks; in the remaining 266 women with a negative test, there were 11 (4.7%) premature deliveries (relative risk = 5.8; 95% CI = 3.3-10.3). The mean values of quantitative phosphorylated isoform of insulin-like growth factor binding protein-1 were 56.9 microg/l (95% CI = 40.7-73.1) in cases of a positive qualitative test and 6.1 microg/l (95% CI = 4.0-8.3; p = 0.0001) in women with a negative result. The sensitivity, specificity, positive predictive value, and negative predictive value for phosphorylated isoform of insulin-like growth factor binding protein-1 test in symptomatic patients were 69.2%, 90.5%, 50%, and 95.6% respectively, while in the asymptomatic patients they were 22.2%, 91.8%, 11.8%, and 96% respectively.


CONCLUSIONS
The phosphorylated isoform of insulin-like growth factor binding protein-1 in cervical secretions is a potential specific marker for preterm delivery occurring before 37 weeks. This test may have an important role in the management of women presenting with symptoms suggestive of preterm labour.
Paternoster
Delia Maria
DM
Department of Gynecological Science and Human Reproduction, University of Padova, Padova, Italy. paternod@unipd.it
Muresan
Dana
D
Vitulo
Anna
A
Serena
Andrea
A
Battagliarin
Giuseppe
G
Dell'avanzo
Marinella
M
Nicolini
Umberto
U
D000328:Adult; D015415:Biomarkers / Q000032:analysis; D002584:Cervix Uteri / Q000737:chemistry* / Q000378:metabolism; D005260:Female; D006801:Humans; D018970:Insulin-Like Growth Factor Binding Protein 1 / Q000032:analysis*; D010766:Phosphorylation; D011237:Predictive Value of Tests; D011247:Pregnancy; D047928:Premature Birth / Q000175:diagnosis*; D011446:Prospective Studies; D020033:Protein Isoforms / Q000032:analysis; D012307:Risk Factors; D012680:Sensitivity and Specificity
D015415:Biomarkers; D018970:Insulin-Like Growth Factor Binding Protein 1; D020033:Protein Isoforms