Cervical length and phosphorilated insulin like growth factor binding protein-1 as the predictors of spontaneus preterm delivery in symptomatic women

Abstract

Uni ver sity Cli nic of Ob ste t rics & Gy ne co l ogy, Me d i cal Fa c ulty, Ss. Cyril and Met ho di us Uni ver sity, Sko pje, Re pu b lic of Ma c e do nia 2 De part ments of Ob ste t rics & Gy ne co l ogy, Me d i cal Fa c ulty Nis, Re pu b lic of Ser bia Pri mljen/Re ce i ved 16. 04. 2014. god. Pri hva }en/Ac cep ted 10. 06. 2014. god. Ab stract: Ob jec ti ve: To as sess the com bi ned use of cer vi cal length and cer vi cal phosp horyla ted in sulin-li ke growth fac tor bin d ing pro tein-1 (phIGFBP-1) in the pre dic tion of pre term de li v ery in symp to m a tic wo men in next 14 days. Met h ods: Cer vi cal length was pro spec ti vely mea su red in 58 con se c u ti ve sin gle ton preg nan ci es with in tact mem bra nes and re g u lar con trac ti ons at 24-36 we eks, and phIGFBP-1 was as ses sed. De mo grap hic da ta was eva l u a ted(hi s tory of pre vi o us pre term de li very,hi s tory of spon ta ne o us abor tion,pa r ity,BMI,ma ternal age, Or t ho dox or Mu s lims). Re sults: Va l u es of all va ri a bles we re eva l u a ted (demo grap hic da ta, cer vi cal length and va l u es of phIGFBP-1) alo ne and in com bi na tion with cer vi cal length of £ 15 mm and mo re than 15 mm. In wo men with cer vi cal length less than 15 mm/ /phIGFPB-1 was po s i ti ve in 30 pa ti ents(22 of them deli v e red in 14 days). In wo men with cer vi cal length less than 15 mm/phIGFBP-1was po s i ti ve in 9 of de li v e red preg nant wo men in 14 days. In wo men with cer vi cal length less than 25 mm/phIGFBP-1was po s i ti ve in 26 pa ti ents (2 of them de li v e red in 14 days). In pa ti ents with cer vi cal length mo re than 25 mm/ph IGFBP-1 was po s i ti ve in 4 pa ti ents (2 of them de li v e red in 14 days). With lo gi s tic re gres sion we con fir med that with OR 0.117 and CI 95% (0.046-0.295) and p < 0.01 odds for pre term birth among pa ti ents with ne g a ti ve phIGFBP-1 is 0.117 lo wer than the odds for pre term birth among pa ti ents with po s i ti ve test re sults. With same test for p = 0.009 (p < 0.01) we con fir med with OR and CI 95% (0.06 to 0.671) that cer vi cal length less than 25 mm is good pre dic tor of pre term de li v ery with symp to m a tic pa ti ents. Pro b a bi l ity for de li v ery in the fol lo w ing 14 days with pa ti ents with po s i ti ve phIGFBP-1and cer vi cal length £ 15 mm is 0.88 or pro b a bi l ity for not de li v e r ing in tho se pa ti ents is 0.12. In 88% pa ti ents with po s i ti ve phIGFBP-1 and cer vi cal length £ 15 mm will de li ver in the fol lo w ing 14 days. Con clu si ons: In symp to m a tic wo men phIGFBP-1 may sig ni f i cantly im pro ve the risk as ses s ment for preterm de li v ery with cer vi cal length and help to plan subse qu ent preg nancy ma n a ge ment.