Phosphorylated IGFBP-1 in predicting successful vaginal delivery in post-term pregnancy

Abstract

PurposeTo estimate whether phosphorylated IGFBP-1 (phIGFBP-1) in cervical secretion in term and post-term pregnancies can predict spontaneous onset of labor or vaginal delivery.MethodsA prospective cohort study of 167 women in singleton term and post-term pregnancies, was conducted at 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, between 2013 and 2014. phIGFBP-1 test (Actim Partus Medix Biochemica), ultrasound cervix assessment and Bishop score were analyzed in the study group. Spontaneous onset of labor was the primary and vaginal delivery was the secondary outcome.ResultsIn 32.5 % of patients, spontaneous uterine contractions appeared. 67.5 % of women delivered vaginally, 32.5 % had cesarean section. phIGFBP-1 test predicted spontaneous onset of labor (sensitivity 0.69, specificity of 0.42) and successful vaginal delivery (0.67, 0.48). In the prediction of spontaneous delivery onset ultrasound cervical assessment and phIBFBP-1 had comparable sensitivity and in the prediction of successful vaginal birth all three tests had comparable sensitivity. The time from preinduction to spontaneous onset of delivery was significantly shorter in women with positive phIGFBP-1 test (13.65 ± 6.7 vs 20.75 ± 2.6 h; p = 0.006).ConclusionA test for phIGFBP1 presence might be an additional tool for predicting both spontaneous onset of labor and successful vaginal delivery in post-term pregnancies.

Insulin-Like Growth Factor Binding Protein-1 versus Cervical Length in Prediction of Successful Induction of Labor after 37 Week. Observational Study

“…Our results are consistent with the study conducted by Kosinska-Kaczynska et al (7) who studied 167 women. IGFBP-1 test, TVUS-CL and Bishop score were studied in the study group where 67.5% of patients delivered vaginally and 32.5% had cesarean section.…”

Premaquick© versus modified Bishop score for preinduction cervical assessment at term: A double‐blind randomized trial

“…Similarly, Cheung et al . and Kosinska‐Kaczynska et al . found a positive association between cervical pIGFBP‐1 and vaginal delivery following induction of labor.…”

“…Among the three biomarkers of Premaquick, two biomarkers (native IGFBP1 and total IGFBP1) have never been evaluated for assessment of induction of labor. Previous studies have only tested phosphorylated IGFBP‐1 compared with Bishop score and or TVUS or TVUS compared with Bishop score, and very recent Cochrane systematic review by Ezebialu et al . indicated that direct comparisons between Bishop score and pIGFBP‐1 and IL‐6 for assessing preinduction cervical ripening among parturients at term gestations was yet to be carried out .…”

“…Several observational studies and nonsystematic reviews have reported the usefulness of cervical ultrasound and testing for the presence of pIGFBP‐1 in comparison with modified Bishop score or transvaginal ultrasound of the cervical length in assessing the ripeness of the cervix for labor induction . The transvaginal ultrasound for the cervical length is thought to be less subjective compared with the Bishop score in assessing preinduction cervical ripening, but the major concern is that it is not clear which cutoff value of sonographically measured cervical length is most likely to indicate benefit from a method of cervical ripening prior to induction of labor …”

Serum Melatonin as a Biomarker for Assessment of Late-term and Postterm Pregnancies in Women without Spontaneous Onset of Labor

“…They suggested that the combined use of ultrasonographic cervical length and a novel biochemical marker like the E3-to-E2 ratio could be a good predictor of successful induction of labor. Kosinska-Kaczynska et al [29] evaluated insulin-like growth factor binding protein-1 (IGFBP-1) in cervical secretion in term and postterm pregnancies can predict spontaneous onset of labor or successful vaginal delivery in pregnant women with induced labor. They found that the phosphorylated IGFBP-1 test may be a predictor of spontaneous onset of labor and successful vaginal delivery in postterm pregnancies.…”