The combination of short cervical length and phIGFBP-1 in the prediction of preterm delivery in symptomatic women

Abstract

Objective. To assess the combined use of cervical length and cervical phosphorylated insulin-like growth factor binding protein-1 (phIGFBP-1) in the prediction of preterm delivery in symptomatic women.

Methods. Cervical length was prospectively measured in 102 consecutive singleton pregnancies with intact membranes and regular contractions at 24–32 weeks, and phIGFBP-1 was assessed in those with a cervix ≤30 mm.

Results. Among women with a cervix >30 mm (n = 42), none delivered <34 weeks or within 7 days. Among women with a cervical length ≤30 mm (n = 60), eight delivered <34 weeks, four of which within 7 days. A positive phIGFBP-1 conferred a significantly increased risk of delivery before 34 weeks in women with a cervix ≤30 mm (likelihood ratio 2.32, 95% confidence interval 1.15–4.67), and a significantly increased risk of delivering within 7 days in the subgroup of women with a cervical length of 20–30 mm (likelihood ratio 3.64, 95% confidence interval 2.20–6.01).

Conclusions. In symptomatic women with a cervical length >30 mm the risk of preterm delivery is very low. In women with a cervix ≤30 mm, adding phIGFBP-1 assessment may improve the risk assessment for preterm delivery, and help to plan subsequent pregnancy management.

Keywords:

• Preterm labor
• transvaginal ultrasound
• sensitivity
• specificity
• predictive value
• likelihood ratio

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.