Accuracy of Phosphorylated Insulin-Like Growth Factor Binding Protein-1 in Predicting Preterm Labour

Preterm birth is the most common cause of perinatal morbidity and mortality worldwide. The routine method for predicting premature birth is the measurement of the cervical length. However, to make a better and more precise prognosis, the cervicovaginal fluid (CVF) was widely inspected through many studies. Its content is used nowadays as a diagnostic method for different conditions. One of the clinical biomarkers used to predict preterm labour in the CVF is the phosphorylated insulin-like growth factor binding protein-1 (pIGFBP-1). This study aimed to evaluate the accuracy of pIGFBP-1 as a predictor of preterm labour when used with cervical biometrics.

A prospective, cross-sectional study was conducted on pregnant patients, divided into groups: Group A included participants at risk for premature labour, and Group B -women with an uncomplicated pregnancy. All patients underwent a test for pIGFBP-1, followed by a transvaginal measurement of the cervical length.

A total of 32 patients were recruited for the study. Their pregnancy outcomes were followed up. In the group of symptomatic patients, the results were positive in 8 patients, and despite the intensive tocolytic therapy given, 5 of them gave preterm birth within 14 days. There were two patients with a cervical length of less than 10 mm. They both had positive results for pIGFBP-1 and gave spontaneous preterm birth within a few hours. The predictive value of pIGFBP-1 in cases with negative results was high.

The leading cause for fetal morbidity and mortality in the twenty-first century remains premature delivery. Many investigations are currently carried out, aiming to facilitate preterm labor prediction and quickly estimate a pregnant woman’s ability to carry to time. The patients at highest risk are detected by measuring the cervical length. Newly searched clinical biomarkers such as fetal fibronectin found in the CVF might help predict preterm birth in time.