Sanamed (Jul 2014)
CERVICAL LENGTH AND PHOSPHORILATED INSULIN LIKE GROWTH FACTOR BINDING PROTEIN-1 AS THE PREDICTORS OF SPONTANEUS PRETERM DELIVERY IN SYMPTOMATIC WOMEN
Abstract
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 in next 14 days. Methods: Cervical length was prospectively measured in 58 consecutive singleton pregnancies with intact membranes and regular contractions at 24–36 weeks, and phIGFBP-1 was assessed. Demographic data was evaluated (history of previous preterm delivery, history of spontaneous abortion, parity, BMI, maternal age, Orthodox or Muslims). Results: Values of all variables were evaluated (demographic data, cervical length and values of phIGFBP-1) alone and in combination with cervical length of ≤15 mm and more than 15 mm. In women with cervical length less than 15 mm/phIGFPB-1 was positive in 30 patients (22 of them delivered in 14 days). In women with cervical length less than 15 mm/phIGFBP-1 was positive in 9 of delivered pregnant women in 14 days. In women with cervical length less than 25 mm/phIGFBP-1was positive in 26 patients (2 of them delivered in 14 days). In patients with cervical length more than 25 mm/ph IGFBP-1 was positive in 4 patients (2 of them delivered in 14 days). With logistic regression we confirmed that with OR 0.117 and CI 95% (0.046–0.295) and p < 0.01 odds for preterm birth among patients with negative phIGFBP-1 is 0.117 lower than the odds for preterm birth among patients with positive test results. With same test for p = 0.009 (p < 0.01) we confirmed with OR and CI 95% (0.06 to 0.671) that cervical length less than 25 mm is good predictor of preterm delivery with symptomatic patients. Probability for delivery in the following 14 days with patients with positive phIGFBP-1and cervical length ≤ 15 mm is 0.88 or probability for not delivering in those patients is 0.12. In 88% patients with positive phIGFBP-1 and cervical length ≤ 15 mm will deliver in the following 14 days. Conclusions: In symptomatic women phIGFBP-1 may significantly improve the risk assessment for preterm delivery with cervical length and help to plan subsequent pregnancy management.
