Prediction of preterm labor by a rapid bedside test detecting phosphorylated insulin-like growth factor-binding protein 1 in cervical secretions.

OBJECTIVE

To evaluate the utility of measuring phosphorylated insulin-like growth factor-binding protein 1 (phIGFBP-1) in cervical secretions to predict preterm birth among women with premature uterine contractions.

METHODS

A prospective study was conducted between September 27, 2013, and February 28, 2014, at a tertiary center in India. Participants with symptoms of preterm labor at 24-36weeks underwent testing for phIGFBP-1 in cervical secretions. Cervical length was measured by ultrasonography.

RESULTS

Cervical swab samples tested positive for phIGFBP-1 among 34 (57%) of the 60 participants. Mean cervical length was 2.15±0.63cm among the 46 (77%) women who delivered preterm and 2.54±0.47cm among the 14 (23%) women who delivered at term. Of the 46 preterm deliveries, 29 (63%) women tested positive for phIGFBP-1 and 17 (37%) tested negative. Mean length of pregnancy at delivery was 32.11±4.09weeks and 35.77±1.68weeks among women who tested positive and negative for phIGFBP-1, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of phIGFBP-1 to predict preterm birth were 86.96%, 35.29%, 64.52%, and 66.67%, respectively.

CONCLUSION

A rapid bedside test measuring phIGFBP-1 identified women at high risk of preterm delivery.