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IGFBP-1 marker of cervical ripening and predictor of preterm birth
Larisa Mešić Ðogić1, Dragana Mićić2, Feđa Omeragić3
1Department of Gynecology and Obstetrics, General Hospital Tešanj; Bosnia and Herzegovina.
Insights
Elevated Insulin-like Growth Factor Binding Protein-1 (IGFBP-1) in cervical secretions strongly indicates premature cervical ripening. This biomarker, detected by the Actim Partus Test (APT), can aid in preventing preterm labor and its complications.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Biomarker Research
Background:
- Preterm labor remains a leading cause of neonatal morbidity and mortality.
- Early identification of women at risk for preterm labor is crucial for timely intervention.
- Cervical ripening is a key indicator of impending preterm labor.
Purpose of the Study:
- To determine the correlation between elevated Insulin-like Growth Factor Binding Protein-1 (IGFBP-1) levels and premature cervical ripening in women experiencing imminent preterm labor.
- To evaluate the diagnostic utility of the Actim Partus Test (APT) for predicting preterm labor.
Main Methods:
- A prospective study involving 50 women with imminent preterm labor and 30 healthy pregnant women (control group).
- IGFBP-1 levels in cervical secretions were assessed using the Actim Partus Test (APT) between weeks 28-37 of gestation.
- Cervical biometry and modified Bishop score were used to diagnose preterm labor.
Main Results:
- IGFBP-1 was positive in 86% of women with imminent preterm labor versus 20% in the control group (p=0.001).
- The APT showed significantly higher positivity in the preterm labor group during early testing (weeks 28-30, p<0.05).
- A strong correlation was observed between elevated IGFBP-1 and preterm labor.
Conclusions:
- Elevated IGFBP-1 in cervical secretions is a reliable indicator of premature cervical ripening and imminent preterm labor.
- Screening for IGFBP-1 using the APT may facilitate the prevention of preterm labor and its adverse outcomes.
- This biomarker holds potential for improving risk assessment and management strategies in high-risk pregnancies.
Abstract:
Aim To establish a correlation between positive values of IGFBP-1(>10 mg/L, Actim Partus Test, APT) and premature cervical ripening in imminent preterm labor. Methods A prospective study was conducted in primary health care centers in Tuzla, Gynecology and Obstetrics Clinic of the University Clinical Centre in Tuzla and General Hospital Tešanj. The study included 50 women (singleton pregnancy, 28-37 week) with imminent preterm labor diagnosed by cervical biometry and modified Bishop score) (examinees) and 30 healthy pregnant women (control group). The presence of IGFBP-1 was tested in cervical secretion several times in weeks 28-37 until a positive test was shown. Results IGFBP-1 was positive in 43 (86%) examinees and in six (20%) patients from the control group (p=0.001). In 31 (62%) examinees APT was positive in weeks 28-30, and in nine (18%) in weeks 31- 33, while three (6%) examinees had positive test in 34-37 week; in the control group, three (10%) were tested positive in weeks 31-33 and three (10%) in weeks 34-37. At first testing (28-30 weeks) APT was statistically significantly more frequently positive in the examined group (p<0.05). Later, tests did not find statistically significant difference in the frequency of positivity between the control and examined group (p=0.08). Conclusion Elevated values of IGFBP -1 in cervical secretion were highly correlated with preterm labor. Screening for IGFBP could help in preventing preterm labor and its complications.
