Cervical phosphorylated insulin-like growth factor binding protein-1 in prediction of preterm delivery

Area of Science:

• Obstetrics and Gynecology
• Reproductive Medicine
• Biomarker Discovery

Background:

• Preterm delivery remains a significant challenge in maternal and neonatal health.
• Accurate prediction of preterm birth is crucial for timely intervention and improved outcomes.
• Current predictive methods have limitations in sensitivity and specificity.

Purpose of the Study:

• To evaluate the phosphorylated insulin-like growth factor binding protein-1 (phIGFBP-1) as a predictor of preterm delivery.
• To assess phIGFBP-1 in endocervical secretions of pregnant women presenting with or without symptoms of preterm labor.
• To determine the diagnostic accuracy of phIGFBP-1 testing in predicting delivery before 37 weeks of gestation.

Main Methods:

• A study involving 105 pregnant patients (24-34 weeks gestation) with uterine contractions and 73 controls.
• Assessment of phIGFBP-1 in cervical secretions using a qualitative, immunochromatographic one-step dipstick test.
• Statistical analysis included Student's t-test, Chi-Square, Fisher's exact test, and Kruskal Wallis variance analysis.

Main Results:

• The preterm birth rate was 19.04% in the study group.
• Patients with a positive phIGFBP-1 test delivered significantly earlier (32.8 weeks) compared to those with a negative test (37.8 weeks) (P<0.05).
• In symptomatic patients, phIGFBP-1 demonstrated a sensitivity of 70% and specificity of 87.05%; in asymptomatic patients, sensitivity was 40% and specificity 82.35%.

Conclusions:

• Cervical phIGFBP-1 is a potential specific marker for preterm delivery before 37 weeks.
• Immunochromatographic detection of cervical phIGFBP-1 is a rapid, easily applicable test.
• This test highly predicts preterm delivery, aiding in clinical decision-making.