Department of Obstetrics and Gynaecology, Helsinki University Central Hospital, Helsinki, Finland.
Prenat Diagn. 2013 Apr;33(4):378-83. doi: 10.1002/pd.4072. Epub 2013 Feb 14.
We aimed to study vaginal fluid phosphorylated insulin-like growth factor binding protein-1 (phIGFBP-1) testing in early pregnancy to predict spontaneous preterm delivery (PTD).
Vaginal and cervical swab samples were collected from 5180 unselected women during the first-trimester (mean gestational age 13.1 weeks) ultrasound screening. PhIGFBP-1 was measured in vaginal and cervical fluid by an immunoenzymometric assay. Concentrations of ≥10 µg/L were considered elevated. The outcome measure was spontaneous PTD at <32 or <37 weeks gestation.
The median concentrations of first-trimester vaginal and cervical phIGFBP-1 were higher in women with spontaneous PTD at <32 and <37 weeks gestation. When 10 µg/L of phIGFBP-1 was used as a cut-off level, the OR in predicting PTD at <32 weeks gestation was 8.6 (95% CI 3.6-20.7) for vaginal samples and 3.6 (95% CI 1.7-7.9) for cervical samples. At <37 weeks gestation, the OR in predicting PTD was 3.0 (95% CI 1.9-3.9) for vaginal samples and 1.9 (95% CI 1.4-2.5) for cervical samples. In multiple logistic regression analysis, both elevated vaginal and cervical fluid phIGFBP-1 levels were independent predictors of PTD both at <32 and <37 weeks gestation.
First-trimester vaginal phIGFBP-1 performed better than cervical phIGFBP-1 in the prediction of spontaneous PTD.
我们旨在研究妊娠早期阴道液中磷酸化胰岛素样生长因子结合蛋白-1（phIGFBP-1）检测对自发性早产（PTD）的预测作用。
在首次超声筛查时，从 5180 名未选择的女性中采集阴道和宫颈拭子样本。通过免疫酶联测定法测量阴道和宫颈液中的 phIGFBP-1。阴道和宫颈 phIGFBP-1 浓度≥10μg/L 被认为升高。结局测量为自发早产<32 周和<37 周。
妊娠早期阴道和宫颈 phIGFBP-1 浓度在自发性早产<32 周和<37 周的女性中较高。当将 10μg/L 的 phIGFBP-1 用作截断值时，阴道样本预测早产<32 周的 OR 为 8.6（95%CI 3.6-20.7），宫颈样本为 3.6（95%CI 1.7-7.9）。在<37 周时，预测早产的 OR 在阴道样本中为 3.0（95%CI 1.9-3.9），在宫颈样本中为 1.9（95%CI 1.4-2.5）。在多变量逻辑回归分析中，升高的阴道和宫颈液 phIGFBP-1 水平均为预测早产<32 周和<37 周的独立预测因素。
妊娠早期阴道 phIGFBP-1 预测自发性早产的表现优于宫颈 phIGFBP-1。
