Predicting preterm delivery in asymptomatic patients with prior preterm delivery by measurement of cervical length and phosphorylated insulin‐like growth factor‐binding protein‐1

Bittar, Roberto Eduardo; Fonseca, Eduardo Borges da; Carvalho, Mário Henrique Burlacchini de; Martinelli, Silvio; Zugaib, Marcelo

doi:10.1002/uog.3989

Cited by 42 publications

(37 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These were conducted with limited sample size. The first such study was conducted in patients who were asymptomatic but at high risk due to previous events by Bittar et al [16], showing improved prediction by sequential combined use of cervical length in mid trimester and phIGFBP-1 detection in early third trimester, predicting 91.7% of early preterm births and 80% of total preterm births. They concluded that two tests are independent, as shown by multivariate analysis.…”

Section: Discussionmentioning

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

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

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

View full text Add to dashboard Cite

show abstract

“…A importância da medida do comprimento do colo uterino e da pesquisa da phIGFBP-1 para a predição do parto prematuro está bem estabelecida na literatura 4,5,7,[14][15][16] , e sua realização se torna de extrema importância para uma assistên-cia pré-natal de qualidade. Considerando que a alteração da flora vaginal se destaca como um dos fatores desencadeantes do parto prematuro, questões vem surgindo a respeito da influência da infecção genital sobre esses marcadores.…”

Section: Discussionunclassified

“…Os mecanismos responsáveis pelo desencadeamento do trabalho de parto, ainda pouco conhecidos, e a etiologia multifatorial, também muitas vezes desconhecida, dificultam a prevenção primária. Dessa forma, a prevenção secundária ganha destaque na medida em que se propõe a identificar aquelas mulheres de maior risco para o parto prematuro pela utilização de marcadores, físicos e bioquímicos, capazes de predizer tal evento, permitindo intervenção em momento oportuno 3,4 . Dentre esses marcadores, vem ganhando destaque nos últimos anos a medida do comprimento do colo uterino (CC) pela ultrassonografia transvaginal (USTV) e a pesquisa de marcadores bioquímicos, como a proteína-1 fosforilada ligada ao fator de crescimento insulina símile (phIGFBP-1) 5,6 .…”

Section: Introductionunclassified

“…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 . Entre os diversos processos fisiopatológicos envolvidos no parto pré-termo destaca-se a infecção genital 12 .…”

Section: Introductionunclassified

“…Para evitar tal influência, alguns estudos relatam em sua metodologia a pesquisa de infecções cervico-vaginais antes da realização dos testes como forma de evitar resultados falso positivos 4,5 . Existe apenas um único estudo que relatou, em sua metodologia, que o teste da phIGFBP-1 não sofre influência pela presença de infecção vaginal 13 .…”

Section: Introductionunclassified

See 2 more Smart Citations

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

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...

show abstract

Microbial and human transcriptome in vaginal fluid at midgestation: Association with spontaneous preterm delivery

Wikström

Abrahamsson

Bengtsson‐Palme

et al. 2022

Clinical & Translational Med

View full text Add to dashboard Cite

Background Intrauterine infection and inflammation caused by microbial transfer from the vagina are believed to be important factors causing spontaneous preterm delivery (PTD). Multiple studies have examined the relationship between the cervicovaginal microbiome and spontaneous PTD with divergent results. Most studies have applied a DNA‐based assessment, providing information on the microbial composition but not transcriptional activity. A transcriptomic approach was applied to investigate differences in the active vaginal microbiome and human transcriptome at midgestation between women delivering spontaneously preterm versus those delivering at term. Methods Vaginal swabs were collected in women with a singleton pregnancy at 18 + 0 to 20 + 6 gestational weeks. For each case of spontaneous PTD (delivery <37 + 0 weeks) two term controls were randomized (39 + 0 to 40 + 6 weeks). Vaginal specimens were subject to sequencing of both human and microbial RNA. Microbial reads were taxonomically classified using Kraken2 and RefSeq as a reference. Statistical analyses were performed using DESeq2. GSEA and HUMAnN3 were used for pathway analyses. Results We found 17 human genes to be differentially expressed (false discovery rate, FDR < 0.05) in the preterm group (n = 48) compared to the term group (n = 96). Gene expression of kallikrein‐2 (KLK2), KLK3 and four isoforms of metallothioneins 1 (MT1s) was higher in the preterm group (FDR < 0.05). We found 11 individual bacterial species to be differentially expressed (FDR < 0.05), most with a low occurrence. No statistically significant differences in bacterial load, diversity or microbial community state types were found between the groups. Conclusions In our mainly white population, primarily bacterial species of low occurrence were differentially expressed at midgestation in women who delivered preterm versus at term. However, the expression of specific human transcripts including KLK2, KLK3 and several isoforms of MT1s was higher in preterm cases. This is of interest, because these genes may be involved in critical inflammatory pathways associated with spontaneous PTD.

show abstract

Predicting preterm delivery in asymptomatic patients with prior preterm delivery by measurement of cervical length and phosphorylated insulin‐like growth factor‐binding protein‐1

Abstract: K E Y W O R D S:

Cited by 42 publications

References 29 publications

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

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

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

Microbial and human transcriptome in vaginal fluid at midgestation: Association with spontaneous preterm delivery

Contact Info

Product

Resources

About