The combination of short cervical length and phIGFBP-1 in the prediction of preterm delivery in symptomatic women.
OBJECTIVE
To assess the combined use of cervical length and cervical phosphorylated insulin-like growth factor binding protein-1 (phIGFBP-1) in the prediction of preterm delivery in symptomatic women.


METHODS
Cervical length was prospectively measured in 102 consecutive singleton pregnancies with intact membranes and regular contractions at 24-32 weeks, and phIGFBP-1 was assessed in those with a cervix ≤30 mm.


RESULTS
Among women with a cervix >30 mm (n = 42), none delivered <34 weeks or within 7 days. Among women with a cervical length ≤30 mm (n = 60), eight delivered <34 weeks, four of which within 7 days. A positive phIGFBP-1 conferred a significantly increased risk of delivery before 34 weeks in women with a cervix ≤30 mm (likelihood ratio 2.32, 95% confidence interval 1.15-4.67), and a significantly increased risk of delivering within 7 days in the subgroup of women with a cervical length of 20-30 mm (likelihood ratio 3.64, 95% confidence interval 2.20-6.01).


CONCLUSIONS
In symptomatic women with a cervical length >30 mm the risk of preterm delivery is very low. In women with a cervix ≤30 mm, adding phIGFBP-1 assessment may improve the risk assessment for preterm delivery, and help to plan subsequent pregnancy management.
Maternal-Fetal Medicine Unit, Department of Obstetrics and Gynaecology, University of Brescia, Italy.
Luana
L
Danti
Federico
F
Prefumo
Andrea
A
Lojacono
Silvia
S
Corini
Alberto
A
Testori
Tiziana
T
Frusca
D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D054791:Cervical Length Measurement; D005260:Female; D006801:Humans; D018970:Insulin-Like Growth Factor Binding Protein 1 / Q000378:metabolism*; D011247:Pregnancy; D047928:Premature Birth / Q000000981:diagnostic imaging* / Q000378:metabolism
D015415:Biomarkers; C032231:IGFBP1 protein, human; D018970:Insulin-Like Growth Factor Binding Protein 1