Document Detail


Comparison of bedside test kits for prediction of preterm delivery: phosphorylated insulin-like growth factor binding protein-1 (pIGFBP-1) test and fetal fibronectin test.
MedLine Citation:
PMID:  17597963     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The objective of the study was to compare the effectiveness of bedside test kits for pIGFBP-1 and fetal fibronectin test in predicting preterm delivery. MATERIALS AND METHODS: Patients presenting with symptoms of preterm labour between 24 and 34 weeks of gestation were recruited. Both pIGFBP-1 and fetal fibronectin bedside tests were performed. Managing obstetricians and patients were blinded to the pIGFBP-1 and fetal fibronectin results. Tocolysis and steroid therapy were administered to all the recruited patients. Outcome data were collected after delivery. RESULTS: One hundred and eight patients were recruited into the study. Fourteen patients had to be excluded from the final analysis due to incomplete data and failure to meet inclusion criteria. Ninety-four patients had complete data for analysis. Among those with negative pIGFBP-1 and fetal fibronectin results, the median [+/-standard deviation (SD)] gestational age at delivery was 37.4 weeks (+/-2.8 weeks) and 37.4 weeks (+/-2.1 weeks), respectively. Among those with positive pIGFBP-1 and fetal fibronectin results, the median (+/-SD) gestational age at delivery was 32.9 weeks (+/-4.0 weeks) and 34.2 weeks (+/-4.2 weeks), respectively (P <0.001 for both pIGFBP-1 and fetal fibronectin). A positive result with either test was associated with a significantly reduced admission-to-delivery interval. The median admission-to-delivery interval was 2.8 weeks shorter in the group with positive pIGFBP-1 results compared to those with a negative pIGFBP-1 result (2.3 weeks compared with 5.1 weeks) (P <0.001). This is 1.8 weeks shorter in the group with positive fibronectin results, compared to those with a negative result (3.3 weeks compared with 5.1 weeks) (P=0.002). Both pIGFBP-1 and fetal fibronectin tests have high negative predictive value (NPV) in predicting risk of delivery within 48 hours, 7, or 14 days (1.00; 0.92; 0.92 and 0.97; 0.89; 0.89, respectively). CONCLUSIONS: Both pIGFBP-1 and fetal fibronectin tests are effective adjuvant bedside test kits for the prediction of preterm delivery in patients presenting with signs or symptoms of preterm labour. pIGFBP-1 has the higher NPV of 1.00 in predicting risk of delivery within 48 hours.
Authors:
Hua-Sieng Ting; Pui-See Chin; George S H Yeo; Kenneth Kwek
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of the Academy of Medicine, Singapore     Volume:  36     ISSN:  0304-4602     ISO Abbreviation:  Ann. Acad. Med. Singap.     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-06-28     Completed Date:  2007-12-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7503289     Medline TA:  Ann Acad Med Singapore     Country:  Singapore    
Other Details:
Languages:  eng     Pagination:  399-402     Citation Subset:  IM    
Affiliation:
MIS Department, Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore.
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MeSH Terms
Descriptor/Qualifier:
Biological Markers / blood
Female
Fibronectins / blood*
Gestational Age
Glycoproteins / blood*
Humans
Insulin-Like Growth Factor Binding Protein 1 / blood*
Obstetric Labor, Premature / blood*,  diagnosis*
Phosphorylation
Point-of-Care Systems*
Predictive Value of Tests
Pregnancy
Pregnancy Outcome*
Prenatal Care
Risk Assessment
Risk Factors
Sensitivity and Specificity
Singapore
Single-Blind Method
Chemical
Reg. No./Substance:
0/Biological Markers; 0/FFN protein, human; 0/Fibronectins; 0/Glycoproteins; 0/Insulin-Like Growth Factor Binding Protein 1

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