Paternoster Delia Maria, Muresan Dana, Vitulo Anna, Serena Andrea, Battagliarin Giuseppe, Dell'avanzo Marinella, Nicolini Umberto
Department of Gynecological Science and Human Reproduction, University of Padova, Padova, Italy.
Acta Obstet Gynecol Scand. 2007;86(2):151-5. doi: 10.1080/00016340600935730.
To evaluate the accuracy of the decidual phosphorylated isoform of insulin-like growth factor binding protein-1 in endocervical secretions to predict premature delivery in symptomatic and asymptomatic pregnant women.
The study included 332 pregnant women: 109 symptomatic patients (study group) and 223 asymptomatic women (control group). For all women, qualitative and quantitative assessment of the decidual phosphorylated isoform of insulin-like growth factor binding protein-1 in endocervical secretions was carried out, but the quantitative assay was finally performed in 282 of 332. Student's test, the chi2 test, and Fisher's exact test were used as appropriate.
The phosphorylated insulin-like growth factor binding protein-1 qualitative test was positive in 35 of 301 women (11.6%) and 11 (31.4%) of them delivered before 37 weeks; in the remaining 266 women with a negative test, there were 11 (4.7%) premature deliveries (relative risk = 5.8; 95% CI = 3.3-10.3). The mean values of quantitative phosphorylated isoform of insulin-like growth factor binding protein-1 were 56.9 microg/l (95% CI = 40.7-73.1) in cases of a positive qualitative test and 6.1 microg/l (95% CI = 4.0-8.3; p = 0.0001) in women with a negative result. The sensitivity, specificity, positive predictive value, and negative predictive value for phosphorylated isoform of insulin-like growth factor binding protein-1 test in symptomatic patients were 69.2%, 90.5%, 50%, and 95.6% respectively, while in the asymptomatic patients they were 22.2%, 91.8%, 11.8%, and 96% respectively.
The phosphorylated isoform of insulin-like growth factor binding protein-1 in cervical secretions is a potential specific marker for preterm delivery occurring before 37 weeks. This test may have an important role in the management of women presenting with symptoms suggestive of preterm labour.
评估宫颈分泌物中胰岛素样生长因子结合蛋白-1的蜕膜磷酸化异构体预测有症状和无症状孕妇早产的准确性。
该研究纳入332名孕妇：109名有症状患者（研究组）和223名无症状女性（对照组）。对所有女性进行宫颈分泌物中胰岛素样生长因子结合蛋白-1的蜕膜磷酸化异构体的定性和定量评估，但最终在332名中的282名中进行了定量测定。酌情使用学生检验、卡方检验和费舍尔精确检验。
301名女性中有35名（11.6%）胰岛素样生长因子结合蛋白-1磷酸化定性试验呈阳性，其中11名（31.4%）在37周前分娩；其余266名试验阴性的女性中有11名（4.7%）早产（相对风险=5.8；95%可信区间=3.3-10.3）。胰岛素样生长因子结合蛋白-1磷酸化异构体定量试验阳性者的平均值为56.9微克/升（95%可信区间=40.7-73.1），试验阴性者为6.1微克/升（95%可信区间=4.0-8.3；p=0.0001）。有症状患者中胰岛素样生长因子结合蛋白-1磷酸化异构体试验的敏感性、特异性、阳性预测值和阴性预测值分别为69.2%、90.5%、50%和95.6%，而无症状患者中分别为22.2%、91.8%、11.8%和96%。
宫颈分泌物中胰岛素样生长因子结合蛋白-1的磷酸化异构体是37周前发生早产的潜在特异性标志物。该试验可能在对有早产迹象症状的女性的管理中发挥重要作用。
