Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Diagnostic accuracy of rapid phIGFBP-I assay for predicting preterm labor in symptomatic patients

Journal of Perinatology volume 32, pages 460–465 (2012)Cite this article

Abstract

Objective:

To estimate sensitivity, specificity, positive and negative predictive values (PPV, NPV) of insulin-like growth factor binding protein-1 (phIGFBP-1) test in predicting preterm delivery in women with symptoms of preterm labor. Secondary objectives were to compare test characteristics of the phIGFBP-1 and fetal fibronectin (fFN) tests.

Study Design:

Labor and delivery units in two Calgary hospitals. Subjects were 349 women with suspected labor between 24 and 35 weeks gestational age (GA). Women had cervical phIGFBP-1 test +/− and fFN testing. Sensitivity, specificity, PPV and NPV were estimated. Primary outcome was birth <37 weeks GA.

Result:

Sensitivity of phIGFBP-1 test for delivery <37 weeks was 0.39; specificity, 0.76; PPV, 0.24; NPV, 0.86. NPV of phIGFBP-1 did not differ greatly from that of fFN testing (0.88).

Conclusion:

NPV did not differ between phIGFBP-1 and fFN for delivery <37 weeks. Neither test improves on pretest probability of delivery <37 weeks, so clinicians must decide whether the use of either test is justified.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Slattery M, Morrison J . Preterm delivery. Lancet 2002; 360 (9344): 1489–1497.

    Article  Google Scholar 

  2. Gilbert WM, Nesbitt TS, Danielsen B . The cost of prematurity: quantification by gestational age and birth weight. Obstet Gynecol 2003; 102 (3): 488–492.

    PubMed  Google Scholar 

  3. Mistry H, Dowie R, Franklin RC, Jani BR . Costs of neonatal care for low-birthweight babies in English hospitals. Acta Paediatr 2009; 98 (7): 1123–1129.

    Article  Google Scholar 

  4. Leitich H, Brunbauer M, Kaider A, Egarter C, Husslein P . Cervical length and dilatation of the internal cervical detected by vaginal ultrasonography as markers for preterm delivery: a systematic review. J Obstet Gynecol 1999; 181: 1465–1472.

    Article  CAS  Google Scholar 

  5. Honest H, Bachmann LM, Gupta JK, Kleijnen J, Khan KS . Accuracy of cervicovaginal fetal fibronectin test in predicting risk of spontaneous preterm birth: systematic review. BMJ 2002; 325 (7359): 301–310.

    Article  Google Scholar 

  6. Rutanen EM . Insulin-like growth factors in obstetrics. Curr Opin Obstet Gynecol 2000; 12: 163–168.

    Article  CAS  Google Scholar 

  7. Goldbenberg RL . The management of preterm labor. Obstet Gynecol 2002; 100: 1020–1037.

    Google Scholar 

  8. Akercan F, Kazandi M, Sendag F, Cirpan T, Mgoyi L, Terek MC et al. Value of cervical phosphorylated insulinlike growth factor binding protein-1 in the prediction of preterm labor. J Reprod Med 2004; 49: 368–372.

    CAS  PubMed  Google Scholar 

  9. Elizur SE, Yinon Y, Epstein GS, Seidman DS, SchiV E, Sivan E . Insulin-like growth factor binding protein-1 detection in preterm labor: evaluation of a bedside test. Am J Perinatol 2005; 22: 305–309.

    Article  Google Scholar 

  10. Kwek K, Khi C, Ting HS, Yeo GS . Evaluation of a bedside test for phosphorylated insulin-like growth factor binding protein-1 in preterm labour. Ann Acad Med Singapore 2004; 33: 780–783.

    CAS  PubMed  Google Scholar 

  11. Lembet A, Eroglu D, Ergin T, Kuscu E, Zeyneloglu H, Batioglu S et al. New rapid bed-side test to predict preterm delivery: phosphorylated insulin-like growth factor binding protein-1 in cervical secretions. Acta Obstet Gynecol Scand 2002; 81: 706–712.

    Article  Google Scholar 

  12. Ting H-S, Chin PS, Yeo G, Kwek K . Comparison of bedside test kits for prediction of preterm delivery: phosphorylated insulin-like growth factor binding protein-1 (pIGFBP-1) test and fetal fibronectin test. Ann Acad Med Singapore 2007; 36: 399–402.

    PubMed  Google Scholar 

  13. Beck B, Wojdyla D, Say L, Pilar Betran A, Merialdi M, Harris Requejo J et al. The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity. Bull World Health Organization 2010; 88: 31–38.

    Article  Google Scholar 

  14. Altinkaya O, Gungor T, Ozat M, Danisman N, Mollamahmutoglu L . Cervical phosphorylated insulin-like growth factor binding protein-1 in prediction of preterm delivery. Arch Gynecol Obstet 2009; 279: 279–283.

    Article  CAS  Google Scholar 

  15. Audibert F, Fortin S, Delvin E, Djemli A, Brunet S, Dubé J . et al. Contingent use of fetal fibronectin testing and cervical length measurement in women with preterm labor. J Obstet Gynaecol Can 2010; 32 (4): 307–312.

    Article  Google Scholar 

  16. Azlin M, Bang H, An L, Mohamad A, Mansor N, Yee B et al. Role of phIGFBP-1 and ultrasound cervical length in predicting pre-term labor. J Obstet Gynaecol 2010; 30: 456–460.

    Article  Google Scholar 

  17. Brik M, Hernandez A, Pedraz C, Perales A . Phosphorylated insulin-like growth factor binding protein-1 and cervical measurement in women with threatening preterm birth. Acta Obstet Gynecol Scand 2010; 89: 268–274.

    Article  CAS  Google Scholar 

  18. Eroglu D, Yanik F, Oktem M, Zeyneloglu HB, Kuscu E . Prediction of preterm delivery among women with threatened preterm labor. Gynecol Obstet Invest 2007; 64: 109–116.

    Article  Google Scholar 

  19. Paternoster D, Muresan D, Vitulo A, Serena A, Battaglirin G, Dell’Avanzo M et al. Cervical phIGFBP-1 in the evaluation of the risk of preterm delivery. Acta Obstet Gynecol Scand 2007; 86: 151–155.

    Article  CAS  Google Scholar 

  20. Rahkonen L, Unkila-Kallio L, Nuutila M, Sainio S, Saisto T, Rutanen EM et al. 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 Obstet Gynecol Scand 2009; 88 (8): 901–908.

    Article  CAS  Google Scholar 

  21. Tanir HM, Sener T, Yildiz Z . Cervical phosphorylated insulin-like growth factor binding protein-1 for the prediction of preterm delivery in symptomatic cases with intact membranes. J Obstet Gynaecol Res 2009; 35 (1): 66–72.

    Article  Google Scholar 

  22. Sanchez-Ramos L, Delke I, Zamora J, Kaunitz A . Fetal fibronectin as a short-term predictor of preterm birth in symptomatic patients, a meta-analysis. Obstet Gynecol 2009; 114: 631–640.

    Article  Google Scholar 

  23. Kornelsen J, Grzybowski S . Is local maternity care an optional service in rural communities? J Obstet Gynaecol Can 2005; 27 (4): 329–331.

    Article  Google Scholar 

  24. Grobman WA, Welshman EE, Calhoun EA . Does fetal fibronectin use in the diagnosis of preterm labor affect physician behaviour and health care costs? A randomized trial. Am J Obstet Gynecol 2004; 191: 235–240.

    Article  CAS  Google Scholar 

  25. Berghella V, Hayes E, Visintine J, Baxter JK . Fetal fibronectin testing for reducing the risk of preterm birth. Cochrane Database Syst Rev 2008; (4): CD006843.

    Google Scholar 

  26. Vis JY, Wilms FF, Oudijk MA, Bossuyt PM, van der Post JA, Grobman WA et al. Why were the results of randomized trials on the clinical utility of fetal fibronectin negative? A systematic review of their study designs. Am J Perinatol 2011; 28 (2): 145–150.

    Article  Google Scholar 

Download references

Acknowledgements

Peer-reviewed funding was received from the Calgary Health Region Perinatal Funding Competition. Somagen Diagnostics provided $300 for staff prize draws of $25.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, University of Calgary, Calgary, Alberta, Canada

    S Cooper, I Lange, S Wood, S Tang, L Miller & S Ross

  2. Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada

    S Wood & S Ross

  3. Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada

    S Ross

  4. Department of Surgery, University of Calgary, Calgary, Alberta, Canada

    S Ross

Authors
  1. S Cooper
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. I Lange
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S Wood
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S Tang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. L Miller
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. S Ross
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S Cooper.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Additional information

Supplementary Information accompanies the paper on the Journal of Perinatology website

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cooper, S., Lange, I., Wood, S. et al. Diagnostic accuracy of rapid phIGFBP-I assay for predicting preterm labor in symptomatic patients. J Perinatol 32, 460–465 (2012). https://doi.org/10.1038/jp.2011.133

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jp.2011.133

Keywords

This article is cited by

Search

Advanced search

Quick links