Role of Insulin-Like Growth Factor Binding Protein-۱ in Cervicovaginal Secretion as a Predictor of Preterm Delivery

Background & Objective: Preterm birth and low birth weight are major health care problems and are significant contributors to perinatal morbidity, mortality, and long-term disability, with nearly ۱۵milion preterm births worldwide per year. The present study was conducted with aim to evaluate the role of Insulin-Like Growth Factor-Binding Protein-۱ (IGFBP-۱) in cervical secretions as a predictor of preterm labor (PTB). The study aimed to evaluate if the phosphorylated isoforms of Insulin-Like Growth Factor-Binding Protein-۱ (IGFBP-۱) can be detect in cervical secretions of pregnant women with threatened preterm labor. Materials & Methods: This case-control study enrolled ۵۰ women (۲۵ patients who presented with symptoms of threatened preterm labor, such as abdominal pain and uterine contraction, but intact fetal membranes at weeks ۲۳-۳۶+۶ days of gestation and ۲۵ asymptomatic pregnant women with the same gestational age) at the Antenatal clinic of the Department of Obstetrics and Gynecology. Phosphorylated IGFBP-۱ (phIGFBP-۱) was measured in cervicovaginal samples obtained at presentation by using an immune enzymometric assay. The values> or=۱۰ng/ml were considered as positive follow-up of the patients for the occurrence of preterm delivery within ۱۲ hours, ۷۲ hours, and ۷ days of hospital admission. In addition, ۲۵ asymptomatic women at the same gestational age were studied as controls. Results: In this study, parity (۲ and above) presented a significant association with risk of PTB (P=۰.۰۵). Similarly, these women showed significantly higher cervicovaginal PhIGFBP۱ levels in the PTB group compared to the control (P=۰.۰۰۱); with PhIGFBP۱ sensitivity level of ۶۴ % and, a specificity level of ۸۸ %, and an accuracy level of ۶۹.۱%. Conclusion: This study showed that cervicovaginal PhIGFBP۱ had a role for identifying patients with a high risk of preterm delivery. This approach would allow precisely tailoring of the required interventions and to target treatment aiming at improving safety of the mother and the adequate maturity of the neonate.

کلیدواژه ها:

Insulin ، growth factor binding protein-۱ ، cervicovaginal secretion ، Preterm delivery