Biochemical markers predicting pre-term delivery in symptomatic patients: phosphorylated insulin-like growth factor binding protein-1 and fetal fibronectin

Riboni, Francesca; Vitulo, Anna; Dell'Avanzo, M.; Plebani, Mario; Battagliarin, G.; Paternoster, Delia Maria

doi:10.1007/s00404-011-1839-4

Cited by 31 publications

(23 citation statements)

References 15 publications

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“…5 Riboni et al found slightly higher predictive values for phIGFBP-1 test than FFN test in predicting pre-term delivery. 4 They observed that phIGFBP-1 and FFN test had a high specificity and a high negative predictive value in predicting pre-term delivery within 7 days (specificity 83.7 Vs 80.2, NPV 97.7 Vs 97.6) before 34 weeks (specificity 85.7 Vs 82.5, NPV 97.1 Vs 96.4) and before 37 weeks (specificity 89.2 Vs 85.9 NPV 90.8 Vs 88) gestation. Another study by Audibert et al found FFN alone or in combination with cervical length had better predictive accuracy than phIGFBP-1 for delivery within 2 weeks.…”

Section: Discussionmentioning

confidence: 99%

“…3 The phIGFBP-1 and FFN bedside dipstick tests hold the promise in identifying those symptomatic women who are least likely to deliver prematurely. 4,5 Studies have been done to predict accuracy of phIGFBP-1 and FFN. 6,7 There have been attempts to combine cervical length with either FFN or phIGFBP-1 to improve the accuracy, however with inconsistent results.…”

Section: Introductionmentioning

confidence: 99%

“…8,9 Certain studies have found FFN better than phIGFBP-1 or vice versa. 4,8 Not enough studies have been published to compare the two tests. In present study we evaluated two rapid bed side tests (FFN and ph IGFBP-1) for prediction of pre-term labor.…”

Section: Introductionmentioning

confidence: 99%

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Double blinded study on comparison of phosphorylated insulin like growth factor binding protein 1 test and fetal fibronectin test for prediction of preterm delivery

Singhal

Sarda

Dhiman

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: Recently new markers like fetal fibronectin (FFN) and phosphorylated Insulin like growth factor binding protein 1 (phIGFBP-1) have been found useful in diagnosis of pre-term labor. Fetal fibronectin (FFN) and phosphorylated Insulin like growth factor binding protein 1 (phIGFBP-1) were compared to predict the risk of pre- term delivery.Methods: Cervicovaginal samples of 50 symptomatic and 50 asymptomatic pregnant women were tested. Statistical analysis was done using chi square test, fisher’s exact test for qualitative data and for quantitative data unpaired student t test and Mann Whitney test were used.Results: For Symptomatic group phosphorylated Insulin like growth factor binding protein 1 (phIGFBP-1) and fetal fibronectin (FFN) had 100% sensitivity and 100% NPV for predicting delivery within 48 hours, 7days and 14 days. Specificity and PPV of FFN was higher than phIGFBP-1 to predict delivery (Specificity: within 48 hours 63.2% vs 52.6% within 7 days 72.7% vs 60.6%, within 14 days 75% vs 62.5%, ≤37 weeks 76% vs 56%; PPV: within 48 hours 46.2% vs 40%, within 7 days 65.4% vs 56.7%, within 14 days was 69.2% vs 60% and ≤37 weeks 76.9% vs 63%).Conclusions: Rapid bed side dip stick tests for detecting FFN and ph IGFBP-1 in cervicovaginal secretions are useful clinical adjuncts in ruling out delivery within 14 days of test in symptomatic patients, thus avoiding unnecessary hospital stay and medical interventions. However, FFN has slightly higher NPV in predicting risk of pre term delivery.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Double blinded study on comparison of phosphorylated insulin like growth factor binding protein 1 test and fetal fibronectin test for prediction of preterm delivery

Singhal

Sarda

Dhiman

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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“…Die breitesten Erfahrungen liegen für das fetale Fibronektion (fFn) vor [17]. In den letzten Jahren wurden Tests auf phosphoryliertes (ph)IGFBP-1 [18] und "placental α-microglobulin-1" (PAMG-1) [19] eingeführt, deren Aussagekra gegenüber dem Fibronektinnachweis höher sein soll. Allen Tests gemeinsam ist die hohe negative Vorhersagekra von über 97%.…”

Section: Biochemische Testsunclassified

Prädiktion, Prävention und Diagnostik

Lachmann

Schleußner

2013

gynäkologie + geburtshilfe

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Obwohl die Frühgeburt die häu gste Komplikation in der Schwangerschaft in Deutschland darstellt, gibt es noch immer keine sicheren diagnostischen Kriterien. Dadurch wird eine Vielzahl von Schwangeren unnötig stationär eingewiesen und medikamentös behandelt, während gleichzeitig bei anderen Frauen die Risiken nicht rechtzeitig erkannt werden. D ie in den letzten Jahren publizierten Erkenntnisse zur Pathophysiologie der Frühgeburt ermöglichen neben der Bestätigung der Diagnose eine Prädiktion der Erkrankung bereits vor dem klinischen Ereignis. Erste Studien zeigen, dass ähnlich dem kombinierten Screening auf Präe-klampsie eine e ektive Erkennung einer Risikopopulation schon im I. Trimenon möglich erscheint [1,2]. Im Rahmen dieser Arbeit soll eine Übersicht über die derzeitigen Möglichkei-ten einer Prädiktion und Diagnostik der drohenden Frühge-burt gegeben werden. Einleitung und HintergrundEine Frühgeburt betri in Europa ca. 6,2%; davon in Deutschland ca. 9%, in Nordamerika und Afrika jeweils ca. 12% aller Schwangerscha en, und ist eine der Hauptursachen für perinatale Morbidität bzw. Mortalität [3][4][5]. Nach WHO-De nition wird jede Geburt < 37+0 Schwangerscha swochen (SSW) als Frühgeburt bezeichnet, wobei besonders Frühgeburten < 34+0 SSW (ca.1 %) von klinischer Bedeutung sind, da mit sinkendem Gestationsalter die Inzidenz von neonataler Morbidität und Mortalität steigt [5].Die drohende Frühgeburt erscheint als multifaktorieller Prozess mit einem gemeinsamen Endpunkt (Abb. 1). Häu gste Ursachen sind aszendierende Infektionen, hypoxisch-ischämi-sche Beeinträchtigungen der utero-plazentaren Einheit, chronischer Stress sowie Fehlbildungen von Fetus und Uterus [6].Bekannte Risikofaktoren sind vor allem eine belastete geburtshil iche Anamnese (vorangegangene Schwangerscha sabbrüche, Spätaborte oder Frühgeburten) (OR 3.4; 95% Kondenzintervall (CI) 1,3-8,7), Alter der Schwangeren > 35 Jahre und < 18 Jahre (OR 1,70, 95% CI 1,02-3,08), Mehrlingsschwangerscha en (etwa 10 % aller Frühgeburten), eine alleinstehende Schwangere (OR 1,61, 95% CI 1,26-2,07) sowie eine niedrige Schulbildung und Ausbildung (OR 1,75 95% CI 1,65-1,86), wodurch die Frühgeburt auch als sozial determiniertes Problem sichtbar wird [7].Die Vielzahl und Komplexität dieser pathophysiologischen Mechanismen, der demographische Wandel mit Verschiebung der Schwangerscha en in mittlere Lebensalter und mangelnde Evidenz therapeutischer Interventionen sind unserer Mei-

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“…The tests are designed to detect the presence of specific biochemical markers associated with preterm birth at concentrations higher than those found in background cervicovaginal fluids. A smaller subset of studies has compared directly the performance of these tests to each other, and while the fFN and phIGFBP-1 tests have proven comparable in several studies [17], the PAMG-1 test was found to be significantly more accurate than the fFN test [18].…”

Section: Introductionmentioning

confidence: 99%

Comparison of PAMG-1 and phIGFBP-1 Tests for the Prediction of Preterm Delivery in Patients with Preterm Labor

Hadzi-Lega¹,

Maier²,

Helmer³

et al. 2017

OJOG

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Objective: To compare PAMG-1 and phIGFBP-1 tests in predicting impending spontaneous preterm delivery within 7 days upon presentation in pregnant women with symptoms of preterm labor. Study Design: From September 2014 to April 2015 women with singleton gestation, symptoms of preterm labor, GA 22 -35, participated in this prospective cohort study upon admission. Recruited patients had intact membranes and a minimal cervical dilatation of ≤3 cm. Vaginal swabs for phIGFBP-1 and PAMG-1 were taken in addition to routine treatment. Biochemical test results were blinded and had no effect on management of patients. Results: A total of 96 patients were screened for inclusion into the trial; 57 met the inclusion criteria for final analysis. The PAMG-1 test was positive in 5.7% of patients, while phIGFBP-1 test was positive in 29.8% of patients. The prediction of spontaneous preterm delivery within 7 days of admission in patients with a cervical length < 25 mm (30%), the PAMG-1 test and phIGFBP-1 test showed a SN of 100% and 100%; SP of 83.3% and 50.0%, (p ≤ 0.05); PPV of 71.4% and 45.5%; and NPV of 100% and 100%. 89.5% of women who received corticosteroids and 84.2% of women who received tocolysis did not go into preterm labor within one week. Conclusion: Our study supports the high negative predictability of biochemical tests to rule out spontaneous preterm labor in patients with a short cervix. However, our study strongly suggests that the PAMG-1 test is more accurate for predicting imminent spontaneous preterm delivery as compared to phIGFBP-1. These findings can significantly reduce economic burden caused by unnecessary admission and treatment of patients suspected of preterm labor. Such a reduction in the use of corticosteroids and tocolytics would lead to a reduction in the short and long term health effects associated with the use of

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Biochemical markers predicting pre-term delivery in symptomatic patients: phosphorylated insulin-like growth factor binding protein-1 and fetal fibronectin

Abstract: The phIGFBP-1 test may be better that the fFN test in predicting pre-term delivery before 34 weeks' gestation.

Cited by 31 publications

References 15 publications

Double blinded study on comparison of phosphorylated insulin like growth factor binding protein 1 test and fetal fibronectin test for prediction of preterm delivery

Double blinded study on comparison of phosphorylated insulin like growth factor binding protein 1 test and fetal fibronectin test for prediction of preterm delivery

Prädiktion, Prävention und Diagnostik

Comparison of PAMG-1 and phIGFBP-1 Tests for the Prediction of Preterm Delivery in Patients with Preterm Labor

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