Insulin‐like growth factor‐binding protein‐1 in cervical secretion as a predictor of preterm delivery

Kekki, M; Kurki, Tapio; Kärkkäinen, Tytti; Hiilesmaa, Vilho; Rutanen, Eeva‐Marja

doi:10.1034/j.1600-0412.2001.080006546.x

Cited by 39 publications

(53 citation statements)

References 23 publications

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“…No que diz respeito à associação entre infecção genital e resultado de phIGFBP-1, Kekki et al 9 demonstraram que 6 das 63 gestantes incluídas no estudo apresentaram infecção genital, das quais 4 tinham teste positivo para phIGFBP-1. O mesmo autor encontrou, em outro artigo 24 , diferença estatisticamente significativa no risco de morbidade infecciosa entre as mulheres que apresentaram vaginose bacteriana e phIGFBP-1 positiva e aquelas com vaginose bacteriana e resultado negativo para tal marcador, demonstrando que a phIGFBP-1 seria um marcador útil para gestantes com vaginose bacteriana que estão mais propensas a desenvolver complicações infecciosas.…”

Section: Discussionunclassified

“…Contrariamente aos resultados obtidos por Kekki et al 9,24 em seus dois estudos, em nossa casuística encontramos fraca correlação entre a presença de infecção genital e a positividade do teste da phIGFBP-1, tanto na divisão por grupos quanto em relação ao total de pacientes. Apenas o estudo de Tanir et al 13 relata que os resultados do teste da phIGFBP-1 não são influenciados por infecções genitais e que as pacientes com resultado positivo não tiveram maior probabilidade de apresentar evidências histológicas de inflamação placentária quando comparadas àquelas com resultado negativo.…”

Section: Discussionunclassified

“…A phIGFBP-1 é uma proteína produzida pela decídua humana que normalmente não é detectada na secreção endocervical entre 24 e 34 semanas de gestação. Se presente nesse intervalo, pode facilitar o diagnóstico de trabalho de parto pré-termo [9][10][11] . Entretanto, sua maior importância reside no elevado valor preditivo negativo, assegurando que, em caso de resultado negativo, há risco mínimo para parto prematuro nos 7 a 10 dias que se seguem à realização do exame 4,5 .…”

Section: Introductionunclassified

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As infecções genitais podem alterar os resultados dos testes preditivos do parto prematuro?

Paganoti

Bittar

Carvalho

et al. 2015

Rev. Bras. Ginecol. Obstet.

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ResumoOBJETIVOS: Verificar se a presença de agentes infecciosos no conteúdo vaginal ou cervical pode alterar os resultados dos testes da proteína-1 fosforilada ligada ao fator de crescimento insulina-símile (phIGFBP-1) e das medidas do comprimento do colo uterino (CC) pela ultrassonografia transvaginal. MÉTODOS: Um total de 107 gestantes com antecedente de prematuridade espontânea foram submetidas ao teste da phIGFBP-1 e à realização da ultrassonografia transvaginal para medida do comprimento do colo uterino, a cada três semanas, entre 24 e 34 semanas. As infecções genitais foram pesquisadas imediatamente antes da realização dos testes. As pacientes foram distribuídas em quatro grupos (GA, GB, GC e GD) e dentro de cada grupo foi avaliada a correlação entre infecção genital e alteração nos testes utilizando a análise das razões de chance (OR) e o coeficiente de correlação de Pearson. RESULTADOS: Em cada grupo, mais de 50% das pacientes apresentaram infecção genital (GA 10/17; GB 28/42; GC 15/24; GD 35/53), sendo a vaginose bacteriana a principal alteração de flora vaginal. O resultado positivo para phIGFBP-1 (GA 10/10; GB 18/28; GC 15/15; GD 19/35) e CC≤20 mm (GA 10/10; GB 20/28; GC 10/15; GD 20/35) foram os resultados encontrados com maior frequência nas pacientes com infecção genital em todos os grupos. Porém, aplicando o coeficiente de correlação de Pearson foi identificada correlação entre infecção genital e positividade para os marcadores. CONCLUSÃO: A presença de alteração da flora vaginal e de outras infecções genitais não alteram significativamente os resultados do teste da phIGFBP-1 e da medida do colo uterino quando comparados aos casos sem infecção. No entanto, é necessária a realização de estudos com maior casuística que comprovem esses resultados. Abstract PURPOSE:To determine if the presence of infectious agents in vaginal or cervical content can alter the results of the insulinlike growth factor binding protein-1 (phIGFBP-1) test and the measurement of cervical length (CC) by transvaginal ultrasonography. METHODS: A total of 107 pregnant women with a history of spontaneous preterm birth were submitted to the phIGFBP-1 test and to measurement of CC by transvaginal ultrasonography every 3 weeks, between 24 and 34 weeks of gestation. Genital infections were determined immediately before testing. The patients were distributed into four groups (GA, GB, GC, and GD) and the correlation between genital infection and changes in the tests was determined within each group based on the odds ratio (OR) and the Pearson correlation coefficient. RESULTS: In each group, over 50% of the patients had genital infections (GA 10/17; GB 28/42; GC 15/24; GD 35/53), with bacterial vaginosis being the main alteration of the vaginal flora. Positive results for phIGFBP-1(GA 10/10; GB 18/28; GC 15/15; GD 19/35) and CC≤20 mm (GA 10/10; GB 20/28; GC 10/15; GD 20/35) were obtained more frequently in patients with genital infection in all groups. Nonetheless, when applying the Pearson correlation coefficient we detected a poor cor...

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Section: Discussionunclassified

Section: Introductionunclassified

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As infecções genitais podem alterar os resultados dos testes preditivos do parto prematuro?

Paganoti

Bittar

Carvalho

et al. 2015

Rev. Bras. Ginecol. Obstet.

View full text Add to dashboard Cite

show abstract

“…Kekki et al [4] were the first authors to demonstrate phIGFBP-1 as a predictor of preterm birth and determined its cut off value in cervicovaginal secretions among patients with threatened preterm labor. This was followed by many studies showing high sensitivity (70-80%) and negative predictive value (79-90%) of the test [8][9][10][11].…”

Section: Discussionmentioning

confidence: 99%

“…Predicting the outcome in patients with threatened preterm labor is important as by treating those who are likely to deliver preterm, perinatal outcome can be improved. The prediction is easier in patients of threatened preterm labor where tests for fetal fibronectin (FFN) and Phosphorylated Insulin like Growth Factor Binding Protien-1(phIGFBP-1) [3,4] and sonologically measured cervical length [5,6] have been used with varying degrees of accuracy.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Phosphorylated Insulin like Growth Factor Binding Protein-1 and Sonographically Measured Cervical Length for Prediction of Preterm Birth in Threatened Preterm Labor: A Clinical Approach

Tripathi¹,

Tyagi²,

Yadav³

et al. 2017

IPCB

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Background and Objectives: Measurement of cervical length using Transvaginal Sonography (TVS) is commonly used to identify those patients of threatened preterm labor who are likely to deliver. Biochemical markers in cervical secretions namely fetal fibronectin and Phosphorylated Insulin like Growth Factor Binding Protien-1 (phIGFBP-1) have also been used to improve predictability. This study evaluated bedside kit test for phIGFBP-1 and cervical length measurement by TVS, individually and in combination, for prediction of preterm birth in patients with threatened preterm labor.

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Rapid cervical phIGFBP-1 test in asymptomatic twin pregnancies: role in mid-pregnancy prediction of spontaneous preterm delivery

et al. 2014

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Objective This study aimed to assess the accuracy of a second-trimester rapid cervical phosphorylated insulin-like growth factor binding protein-1 (phIGFBP-1) test to predict spontaneous preterm delivery in asymptomatic twin pregnancies. Method During the second trimester, a rapid test to detect phIGFBP-1 in cervical secretions was performed on consecutive twin pregnancies between 2009 and 2011, to evaluate its predictive value for spontaneous preterm delivery at <28, <30, <32 and <34 weeks' gestation. Excluded were patients with cerclage, pessary or undergoing indicated preterm delivery. Results A total of 197 pregnancies fulfilled the study criteria and were tested at a median gestational age of 20.3 weeks (interquartile range: 20-20.6). Median gestational age at delivery was 36.4 weeks. Spontaneous preterm delivery at <34 weeks occurred in 21 (10.7%) cases, at <32 weeks in 9 (4.5%), at <30 weeks in 6 (3%) and at <28 weeks in 4 (2%). Seventeen patients (8.7%) were test positive: In this group, three patients delivered before 34 weeks' gestation, whereas none delivered at <32 weeks. The sensitivity, specificity, positive and negative predictive value of the test for spontaneous preterm delivery <34 weeks were 14% (95% confidence interval, 3-37%), 92% (86-95%), 17% (4-44%) and 90% (84-93%), respectively, with a positive and negative likelihood ratio of 1.79 (0.56-5.74) and 0.93 (0.78-1.10). Conclusions In the second trimester, rapid cervical phIGFBP-1 testing in asymptomatic twin pregnancies has a poor performance in predicting spontaneous preterm delivery.

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Insulin‐like growth factor‐binding protein‐1 in cervical secretion as a predictor of preterm delivery

Abstract: Pregnant women who are in preterm labor with intact fetal membranes and who have a positive phIGFBP-1 test result in cervical secretion have an increased risk of preterm delivery.

Cited by 39 publications

References 23 publications

As infecções genitais podem alterar os resultados dos testes preditivos do parto prematuro?

As infecções genitais podem alterar os resultados dos testes preditivos do parto prematuro?

Evaluation of Phosphorylated Insulin like Growth Factor Binding Protein-1 and Sonographically Measured Cervical Length for Prediction of Preterm Birth in Threatened Preterm Labor: A Clinical Approach

Rapid cervical phIGFBP-1 test in asymptomatic twin pregnancies: role in mid-pregnancy prediction of spontaneous preterm delivery

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