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Published on: June 29, 2013
Early midtrimester serum insulin-like factors and cervical length to predict preterm delivery
Jae Eun Shin1, Jong Chul Shin1, Sa Jin Kim1
1Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Insights
Cervical length (CL) and insulin-like growth factor binding protein 3 (IGFBP-3) measured in early pregnancy are key predictors for preterm delivery. These biomarkers help identify asymptomatic women at higher risk for early birth.
Area of Science:
- Perinatal Medicine
- Biomarker Discovery
- Obstetric Ultrasound
Background:
- Preterm delivery remains a leading cause of neonatal morbidity and mortality.
- Early identification of at-risk pregnancies is crucial for timely intervention.
- Existing prediction methods for preterm birth have limitations.
Purpose of the Study:
- To identify the most effective ultrasound findings and serum biomarkers for predicting preterm delivery.
- To evaluate biomarkers including insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding proteins (IGFBP-1, IGFBP-3) in early pregnancy.
- To determine the predictive value of these markers in asymptomatic women.
Main Methods:
- A case-control study involving 72 women (24 preterm, 48 term delivery).
- Serum samples collected at 11-18 weeks gestation.
- Cervical length (CL) measured at 18-21 weeks.
- Multivariate logistic regression and ROC curves used for analysis.
Main Results:
- Maternal serum concentration of IGFBP-3 was significantly associated with preterm birth.
- Cervical length (CL) was also significantly associated with preterm birth.
- IGF-1, IGFBP-1 did not show significant association.
Conclusions:
- Cervical length (CL) and serum IGFBP-3 are independent predictors of preterm delivery.
- These markers are valuable in the early midtrimester for risk assessment in asymptomatic women.
- This finding aids in the early detection of pregnancies at risk for preterm birth.
Objective:
To investigate which ultrasound findings or serum biomarkers, including insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 1 and 3 (IGFBP-1 and IGFBP-3, respectively), in the first and early second trimesters are the best predictors for preterm delivery.
Materials And Methods:
This was a case-control study conducted between March 2011 and March 2013 with women presenting for routine antenatal care at 11-18 weeks. We collected serum samples from pregnant women and stored them at -80°C. All patients underwent cervical length (CL) measurement at 18-21 weeks. We retrieved frozen samples for analysis from women with subsequent preterm and term delivery. Prediction models were developed using multivariate stepwise logistic regression. Receiver-operating characteristics curves were used to determine the most useful cutoff point.
Results:
Of the 72 women recruited, 24 women underwent spontaneous preterm delivery, and 48 women with term delivery were randomly selected as the control group, in a 1:2 ratio. The maternal serum concentration of IGFBP-3 and CL were significantly associated with preterm birth.
Conclusion:
Among the various known ultrasound findings and serum biomarkers in the early midtrimester, only CL and IGFBP-3 are independent predictors for preterm delivery in asymptomatic women.
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