title: Early pregnancy vaginal fluid phosphorylated insulin-like growth factor binding protein-1 predicts preterm delivery.
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.
  
  
  CONCLUSIONS
  First-trimester vaginal phIGFBP-1 performed better than cervical phIGFBP-1 in the prediction of spontaneous PTD.
authors: Department of Obstetrics and Gynaecology, Helsinki University Central Hospital, Helsinki, Finland. hanna.kallioniemi@hus.fi
authors: Hanna
authors: H
authors: Kallioniemi
authors: Leena
authors: L
authors: Rahkonen
authors: Oskari
authors: O
authors: Heikinheimo
authors: Jorma
authors: J
authors: Paavonen
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000032:analysis; D005260:Female; D006801:Humans; D018970:Insulin-Like Growth Factor Binding Protein 1 / Q000032:analysis*; D008875:Middle Aged; D011237:Predictive Value of Tests; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D047928:Premature Birth; D011446:Prospective Studies; D014626:Vaginal Smears; D055815:Young Adult
chemical_list: D015415:Biomarkers; C032231:IGFBP1 protein, human; D018970:Insulin-Like Growth Factor Binding Protein 1