open access

Vol 89, No 6 (2018)
Research paper
Published online: 2018-06-29
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Rapid cervical phIGFBP-1 test in asymptomatic twin pregnancies is inefficient in predicting preterm delivery prior to 34 gestational weeks

Katarzyna Kosińska-Kaczyńska1, Iwona Szymusik1, Dorota Bomba-Opoń1, Aleksandra Zyguła1, Mirosław Wielgoś1
DOI: 10.5603/GP.a2018.0055
·
Pubmed: 30010181
·
Ginekol Pol 2018;89(6):321-325.
Affiliations
  1. 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland

open access

Vol 89, No 6 (2018)
ORIGINAL PAPERS Obstetrics
Published online: 2018-06-29

Abstract

Objectives: To assess the effectiveness of a rapid second trimester test for cervical phIGFBP-1 in the prediction of sponta­neous preterm delivery prior to 34 weeks in asymptomatic twin pregnancies.

Material and methods: A prospective observational study conducted on 232 twin pregnancies tested for phIGFBP-1 at 20–24 weeks of gestation. 151 patients assessed as asymptomatic, with cervical length > 25 mm at 20–24 weeks were analysed. The primary outcome was the delivery < 34 weeks of gestation.

Results: The spontaneous preterm delivery before completing 34 weeks occurred in 23 patients (15.2%), including 9 in dichorionic and 14 in monochorionic pregnancies. The sensitivity of phIGFBP-1 test was 0.39 and specificity 0.63 in predicting delivery before 34 gestational weeks. phIGFBP-1 had a low positive predictive value of 0.16 and high negative predictive value (0.85). Both positive and negative predictive values of delivery < 34 weeks were close to 1.

Conclusions: A test for phIGFBP1 presence is not an effective additional tool for predicting preterm delivery before 34 weeks in twin gestation.

Abstract

Objectives: To assess the effectiveness of a rapid second trimester test for cervical phIGFBP-1 in the prediction of sponta­neous preterm delivery prior to 34 weeks in asymptomatic twin pregnancies.

Material and methods: A prospective observational study conducted on 232 twin pregnancies tested for phIGFBP-1 at 20–24 weeks of gestation. 151 patients assessed as asymptomatic, with cervical length > 25 mm at 20–24 weeks were analysed. The primary outcome was the delivery < 34 weeks of gestation.

Results: The spontaneous preterm delivery before completing 34 weeks occurred in 23 patients (15.2%), including 9 in dichorionic and 14 in monochorionic pregnancies. The sensitivity of phIGFBP-1 test was 0.39 and specificity 0.63 in predicting delivery before 34 gestational weeks. phIGFBP-1 had a low positive predictive value of 0.16 and high negative predictive value (0.85). Both positive and negative predictive values of delivery < 34 weeks were close to 1.

Conclusions: A test for phIGFBP1 presence is not an effective additional tool for predicting preterm delivery before 34 weeks in twin gestation.

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Keywords

twin pregnancy, preterm birth, IGFBP test, preterm delivery screening tests, multiple gestation

About this article
Title

Rapid cervical phIGFBP-1 test in asymptomatic twin pregnancies is inefficient in predicting preterm delivery prior to 34 gestational weeks

Journal

Ginekologia Polska

Issue

Vol 89, No 6 (2018)

Article type

Research paper

Pages

321-325

Published online

2018-06-29

DOI

10.5603/GP.a2018.0055

Pubmed

30010181

Bibliographic record

Ginekol Pol 2018;89(6):321-325.

Keywords

twin pregnancy
preterm birth
IGFBP test
preterm delivery screening tests
multiple gestation

Authors

Katarzyna Kosińska-Kaczyńska
Iwona Szymusik
Dorota Bomba-Opoń
Aleksandra Zyguła
Mirosław Wielgoś

References (18)
  1. Garabedian C, Poulain C, Duhamel A, et al. Intrapartum management of twin pregnancies: are uncomplicated monochorionic pregnancies more at risk of complications than dichorionic pregnancies? Acta Obstet Gynecol Scand. 2015; 94(3): 301–307.
  2. Tarter JG, Khoury A, Barton JR, et al. Demographic and obstetric factors influencing pregnancy outcome in twin gestations. Am J Obstet Gynecol. 2002; 186(5): 910–912.
  3. Goldenberg RL, Iams JD, Das A, et al. The preterm prediction study: risk factors in twin gestations. National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Am J Obstet Gynecol. 1996; 175(4 Pt 1): 1047–1053.
  4. Bibby E, Stewart A. The epidemiology of preterm birth. Neuro Endocrinol Lett. 2004; 25 Suppl 1: 43–47.
  5. Burgess JL, Unal ER, Nietert PJ, et al. Risk of late-preterm stillbirth and neonatal morbidity for monochorionic and dichorionic twins. Am J Obstet Gynecol. 2014; 210(6): 578.e1–578.e9.
  6. Brubaker SG, Gyamfi C. Prediction and prevention of spontaneous preterm birth in twin gestations. Semin Perinatol. 2012; 36(3): 190–194.
  7. Nuutila M, Hiilesmaa V, Kärkkäinen T, et al. Phosphorylated isoforms of insulin-like growth factor binding protein-1 in the cervix as a predictor of cervical ripeness. Obstet Gynecol. 1999; 94(2): 243–249.
  8. Kekki M, Kurki T, Kärkkäinen T, et al. Insulin-like growth factor-binding protein-1 in cervical secretion as a predictor of preterm delivery. Acta Obstet Gynecol Scand. 2001; 80(6): 546–551.
  9. Lembet A, Eroglu D, Ergin T, et al. New rapid bed-side test to predict preterm delivery: phosphorylated insulin-like growth factor binding protein-1 in cervical secretions. Acta Obstet Gynecol Scand. 2002; 81(8): 706–712.
  10. Conde-Agudelo A, Romero R, Hassan SS, et al. Transvaginal sonographic cervical length for the prediction of spontaneous preterm birth in twin pregnancies: a systematic review and metaanalysis. Am J Obstet Gynecol. 2010; 203(2): 128.e1–128.12.
  11. Balić D, Latifagić A, Hudić I. Insulin-like growth factor-binding protein-1 (IGFBP-1) in cervical secretions as a predictor of preterm delivery. J Matern Fetal Neonatal Med. 2008; 21(5): 297–300.
  12. Goyal M, Kriplani A, Kachhawa G, et al. Prediction of preterm labor by a rapid bedside test detecting phosphorylated insulin-like growth factor-binding protein 1 in cervical secretions. Int J Gynaecol Obstet. 2016; 134(2): 165–168.
  13. Elizur SE, Yinon Y, Epstein GS, et al. Insulin-like growth factor binding protein-1 detection in preterm labor: evaluation of a bedside test. Am J Perinatol. 2005; 22(6): 305–309.
  14. Rahkonen L, Rutanen EM, Nuutila M, et al. Elevated levels of decidual insulin-like growth factor binding protein-1 in cervical fluid in early and mid-pregnancy are associated with an increased risk of spontaneous preterm delivery. BJOG. 2010; 117(6): 701–710.
  15. Cooper S, Lange I, Wood S, et al. Diagnostic accuracy of rapid phIGFBP-I assay for predicting preterm labor in symptomatic patients. J Perinatol. 2012; 32(6): 460–465.
  16. Kallioniemi H, Rahkonen L, Heikinheimo O, et al. Early pregnancy vaginal fluid phosphorylated insulin-like growth factor binding protein-1 predicts preterm delivery. Prenat Diagn. 2013; 33(4): 378–383.
  17. Adeyemi O, Osoba L. The role of phosphorylated insulin-like growth factor binding protein-1 in predicting pre-term labour in twin pregnancies. J Obstet Gynaecol. 2010; 30(6): 571–573.
  18. Fichera A, Prefumo F, Zanardini C, et al. Rapid cervical phIGFBP-1 test in asymptomatic twin pregnancies: role in mid-pregnancy prediction of spontaneous preterm delivery. Prenat Diagn. 2014; 34(5): 450–459.

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