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

J Perinatol. 2012 Jun;32(6):460-5. doi: 10.1038/jp.2011.133. Epub 2011 Oct 13.

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.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Cervix Mucus / chemistry*
  • Female
  • Fibronectins / analysis*
  • Humans
  • Infant, Newborn
  • Infant, Premature, Diseases
  • Insulin-Like Growth Factor Binding Protein 1 / analysis*
  • Middle Aged
  • Obstetric Labor, Premature / diagnosis*
  • Predictive Value of Tests
  • Pregnancy
  • Pregnancy Complications
  • Premature Birth / diagnosis*
  • Prospective Studies
  • Sensitivity and Specificity
  • Vagina / chemistry
  • Young Adult

Substances

  • FFN protein, human
  • Fibronectins
  • Insulin-Like Growth Factor Binding Protein 1