Kekki M, Kurki T, Kärkkäinen T, Hiilesmaa V, Paavonen J, Rutanen E M
Department of Obstetrics and Gynecology, Helsinki University Central Hospital, and Medix Biochemica, Kauniainen, Finland.
Acta Obstet Gynecol Scand. 2001 Jun;80(6):546-51.
The aim of the study was to evaluate whether the phosphorylated isoforms of insulin-like growth factor-binding protein-1 (IGFBP-1), a protein produced by the decidua, can be detected in cervical secretions of pregnant women with preterm uterine contractions, and whether their presence predicts an increased risk of preterm delivery.
A prospective analysis of sixty-three women who presented with preterm labor but intact fetal membranes at weeks 22-36+6 days of gestation at the Antenatal clinic at the Department of Obstetrics and Gynecology, Helsinki University Central Hospital. Phosphorylated IGFBP-1 (phIGFBP-1) was measured in cervical swab samples obtained at presentation, using an immunoenzymometric assay. The values > or =10 microg/L were considered as positive. In addition, 58 asymptomatic women at the same gestational stage were studied as controls. Multiple logistic regression was applied to control for confounding variables and to obtain adjusted odds ratios.
The concentration of phIGFBP-1 in cervical samples ranged from undetectable to 95 microg/L. In 17 of the 63 (27%) women with preterm labor it was > or =10 microg/L. Seven of these 17 (41%) women with a positive phIGFBP-1 result delivered preterm, all before 35 weeks of gestation. Among the women with preterm labor and a negative phIGFBP-1 result, three of the 46 (7%) delivered before 37 weeks of gestation (adjusted OR 24, 95% CI 1.2-487), but all after 35 weeks of gestation. In the asymptomatic control population three out of 58 (5%) women had a positive cervical phIGFBP-1 test result but none delivered preterm. Among the controls with a negative cervical phIGFBP-1 test result (55 of 58, 95%), one woman delivered preterm (1 of 55, 2%).
Pregnant women who are in preterm labor with intact fetal membranes and who have a positive phIGFBP-1 test result in cervical secretion have an increased risk of preterm delivery.
本研究旨在评估胰岛素样生长因子结合蛋白-1（IGFBP-1）的磷酸化异构体（一种由蜕膜产生的蛋白质）能否在有子宫收缩的早产孕妇的宫颈分泌物中被检测到，以及其存在是否预示早产风险增加。
对赫尔辛基大学中心医院妇产科产前门诊63例妊娠22至36 + 6周出现早产但胎膜完整的妇女进行前瞻性分析。使用免疫酶分析法测量就诊时采集的宫颈拭子样本中的磷酸化IGFBP-1（phIGFBP-1）。值≥10μg/L被视为阳性。此外，研究了58例处于相同孕周的无症状妇女作为对照。应用多因素逻辑回归来控制混杂变量并获得调整后的比值比。
宫颈样本中phIGFBP-1的浓度范围为无法检测到至95μg/L。63例早产妇女中有17例（27%）≥10μg/L。这17例phIGFBP-1结果为阳性的妇女中有7例（41%）早产，均在妊娠35周前。在phIGFBP-1结果为阴性的早产妇女中，46例中有3例（7%）在妊娠37周前分娩（调整后的比值比为24，95%可信区间为1.2 - 487），但均在妊娠35周后。在无症状对照人群中，58例中有3例（5%）宫颈phIGFBP-1检测结果为阳性，但均未早产。在宫颈phIGFBP-1检测结果为阴性的对照中（58例中的55例，95%），1例妇女早产（55例中的1例，2%）。
胎膜完整且宫颈分泌物phIGFBP-1检测结果为阳性的早产孕妇早产风险增加。
