Double blinded study on comparison of phosphorylated insulin like growth factor binding protein 1 test and fetal fibronectin test for prediction of preterm delivery
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20171390Keywords:
Actim partus test, Cervical length, Fetal fibronectin test, Phosphorylated insulin like growth factor binding protein 1 test, Preterm delivery, Quik chek testAbstract
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.
References
Goldenberg RL, Mercer BM, Meis PJ, Cooper RL, Das A, McNellis D. The preterm prediction study: fetal fibronectin testing and spontaneous preterm birth. NICHD Maternal Fetal Medicine Units Network. Obstet Gynecol. 1997;87:643-48.
Sunagawa S, Takagi K, Ono K, Miyachi K, Kikuchi A. Comparison of biochemical markers and cervical length for predicting preterm delivery. J Obstet Gynaecol Res. 2008;34(5):812-9.
Rahkonen L, Kalio LU, Nuutila M, Sainio S, Saisto T, Paavonenet J. Cervical length measurement and cervical phosphorylated insulin-like growth factor binding protein-1 testing in prediction of preterm birth in patients reporting uterine contractions. Acta Obstetricia et Gynecologica. 2009;88:901-8.
Riboni F, Vitulo A, Avanzo MD, Plebani M, Battagliarin G, Patemoster D. Biochemical markers predicting pre-term delivery in symptomatic patients: phosphorylated insulin-like growth factor binding protein-1 and fetal fibronectin. Arch Gynecol Obstet. 2011;284:1325-29.
Ting H.S. Chin PS, Yeo GS, Kwek K. Comparison of bed side test kits for prediction of pre-term delivery: n-phosphorylated Insulin like growth factor binding protein 1 test and fetal fibronectin test. Ann Acad med Singapore. 2007;36(6):399-402.
Kekki M, Kurki T, Karkkainen T, Hiilesmaa V, Paavonen J, Rutanen EM. Insulin-like growth factor-binding protein-1 in cervical secretion as a predictor of preterm delivery. Acta Obstet Gynecol Scand. 2001;80:546-51
Tekesin I, Marek S, Hellmeyer L, Reitz D, Schmidt S. Assessment of rapid fetal fibronectin in predicting pre term delivery. Obstet Gynecol. 2005;105(2):280-4.
Audibert F, Fortin S, Delvin E, Djemli A, Brunet S, Dube J, Fraser WD. Contingent Use of Fetal Fibronectin Testing and Cervical Length Measurement in Women With Preterm Labour. J Obstet Gynaecol Can. 2010;32(4):307-12.
Nor Azlin MI, Bang HK, An LJ, Mohamad SN, Mansor NA, Yee BS, et al. Role of phIGFBP-1 and ultrasound cervical length in predicting pre-term labour. J Obstet Gynaecol. 2010;30(5):456-60.
Vogel I, Thorsen P, Curry A, Sandager P, Uldbjerg N. Biomarkers for prediction of preterm delivery. Acta Obstet Gynecol Scand. 2005;84(6):516-25.
Deshpande SN, Van Asselt ADI, Tomini F, Armstrong N, Allen A, Noake C, et al. Rapid fetal fibronectin testing to predict preterm birth in women with symptoms of premature labour: a systematic review and cost analysis. Health Technol Assess. 2013;17:40.
Altinkaya O, Gungor T, Ozat M, Danisman M, Mollamahmutoglu L. 2009.Cervical phosphorylated insulin-like growth factor bindingprotein-1 in prediction of preterm delivery. Arch Gynecol Obstet. 2009;279(3):279-83.
Tanir HM, Sener T, Yildiz Z. Cervical phosphorylated insulin like growth factor binding protein -1 for the prediction of pre-term delivery in symptomatic cases with intact membranes. J Obstet Gynaecol Res. 2009;35(1):66-72.
Danti L, Prefumo F, Lojacono A, Corini S, Testori A, Frusca T. The combination of short cervical length and Ph IGFBP-1 in the prediction of pre-term delivery in symptomatic women. J Matern Fetal Neona. 2011;24(10):1262-6.
Paternoster D, Riboni F, Vitulo A, Plebani M, Avanzo MD, Battagliarin, Surico N, Nicolini U. Phosphorylated insulin-like growth factor binding protein-1 in cervical secretions and sonographic cervical length in the prediction of spontaneous preterm delivery. Ultrasound Obstet Gynecol. 2009;34:437-40.
Tripathi R, Tyagi S, Singh N, Mala YM, Singh C, Bhalla P, Ramji S. Can preterm labour be predicted in low risk pregnancies? Role of clinical, sonographic, and biochemical markers. J pregnan. 2014;22:7.
Akercan F, Kazandi M, Sendag F, Cirpan T, Mgoyi L, Terek MC, Sagol S. Value of cervical phosphorylated insulin like growth factor binding protein 1 in the prediction of pre-term labor. J Reprod Med. 2004;49(5):368-72.
Faron G, Buyl R, Foulon W. Does recent sexual intercourse during pregnancy affect the results of the fetal fibronectin rapid test? A comparative prospective study. J Perinat Med. 2015;43(4):403-8.
Tripathi R, Tyagi S, Mala YM, Singh N, Pandey NB, Yadav P. Comparison of rapid bedside tests for phosphorylated insulin-like growth factor-binding protein 1 and fetal fibronectin to predict preterm birth. Int J Gynaecol Obstet. 2016;135(1):47-50.
