Use of cervicovaginal PAMG-1 protein as a predictor of delivery within seven days in pregnancies at risk of premature birth

Abstract

BackgroundTo investigate the utility of vaginal placental alpha microglobulin-1 (PAMG-1) protein as a predictor of preterm delivery within 7 days in pregnancies at risk of premature birth.MethodsThis prospective study was performed in women at risk of premature birth. The levels of vaginal PAMG-1 and foetal fibronectin (fFN) and the transvaginal cervical length measurement (CLM) were investigated and compared.ResultsSeventy-two pregnant women were included in this study. The sensitivities of PAMG-1, fFN and CLM were 73.3, 73.6%, and 52.9%, respectively, while the specificities of PAMG-1, fFN and CLM were 92.9%, 94.3%, and 90.9%, respectively. The positive predictive values of PAMG-1, fFN and CLM were 73.3%, 82.3%, and 64.2%, respectively, and the negative predictive values of PAMG-1, fFN and CLM were 92.9%, 90.9%, and 86.2%, respectively.ConclusionThe diagnostic accuracy of PAMG-1 is similar to that of fFN in terms of preterm labour detection within 7 days.

Prediction of preterm delivery in symptomatic women using PAMG‐1, fetal fibronectin and phIGFBP‐1 tests: systematic review and meta‐analysis

“…Overall, 14 studies ( n = 2278 women) reporting on PAMG‐1, 40 ( n = 7431 women) on fFN and 22 ( n = 3192 women) on phIGFBP‐1 were included in the final analysis. Of these, 11 studies included performance metrics for more than one biomarker.…”

“…Three studies ( n = 1074 women) reporting on PAMG‐1, eight studies ( n = 2667 women) reporting on fFN and two studies ( n = 559 women) on phIGFBP‐1 met the criteria to be included in the low‐risk group. Nine studies ( n = 929 women) reporting on PAMG‐1, 25 studies ( n = 3714 women) on fFN and eight ( n = 1108 women) on phIGFBP‐1 were allocated to the intermediate‐risk group, while two studies ( n = 275 women) on PAMG‐1, seven ( n = 1050 women) on fFN and 12 studies ( n = 1525) on phIGFBP‐1 were allocated to the high‐risk group. Table shows pooled summary sensitivity and specificity results for each biomarker test, overall and according to risk group, from the bivariate mixed model, with each diagnostic test as a covariate.…”

“…Overall, 14 studies (n = 2278 women) 15,17,20,21,30,40-48 reporting on PAMG-1, 40 (n = 7431 women) 14,15,18,20,22,28,29,[40][41][42] on fFN and 22 (n = 3192 women) 16,18,19,28,30,48,54,73,[79][80][81][82][83][84][85][86][87][88][89][90][91][92] on phIGFBP-1 were included in the final analysis. Of these, 11 studies included performance metrics for more than one biomarker.…”

“…The sample size of the included studies ranged from 22 77 to 725 52 (mean, 158) subjects. 20 Fatkullin (2016) 45 Hadzi-Lega (2017) 48 Heverhagen (2015) 17 Konoplyannikov (2016) 47 Lotfi (2015) 44 Lou (2016) 46 Melchor (2018) 40 Nikolova (2015) 42 Nikolova (2017) 30 Ravi (2017) 43 Van Holsbeke (2016) 41 Wing (2017) Bartnicki (1996) 49 Benattar (1997) 62 Bruijn (2016) 28 Çekmez (2017) 20 Cheung (2013) 77 Closset (2001) 68 Desjardins (2008) 53 Diaz (2009) 75 Eroglu (2007) 73 Foxman (2004) 56 Gao (2014) 22 Giles (2000) 71 Gomez (2005) 74 Groom (2006) 59 Henrich (2010) 60 Iams (1995) 14 LaShay (2000) 55 Liong (2015) 66 Lopez (2000) 70 Lowe (2004) 63 Luzzi (2003) 58 MacDonald (2007) 50 Magro-Malosso (2017) 78 Malak (1996) 65 McKenna (1999) 72 Melchor (2018) 40 Nikolova (2015) 42 Peaceman (1997) 52 Riboni (2011) 54 Sakai (2003) 51 Senden (1996) 76 Skoll (2006) …”

“…Concomitantly, the predictive values associated with each biomarker also vary. Positive predictive values (PPV) for PAMG‐1, fFN and phIGFBP‐1 range from 23.1% to 100%, 4.3% to 92.3% and 2.2% to 81.3%, respectively, and negative predictive values (NPV) range from 93.0% to 100%, 73.2% to 100% and 61.8% to 98.4%, respectively. The range of predictive values presents a challenge to clinicians evaluating biomarker tests of their population, which may have a different pretest probability of sPTB ≤ 7 days from that reported by any one study.…”