Document Detail


Elevated levels of decidual insulin-like growth factor binding protein-1 in cervical fluid in early and mid-pregnancy are associated with an increased risk of spontaneous preterm delivery.
MedLine Citation:
PMID:  20374609     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To study whether elevated levels of decidual insulin-like growth factor binding protein-1 (IGFBP-1) in the cervical fluid of unselected asymptomatic women in early or mid-pregnancy are associated with spontaneous preterm delivery (PTD). DESIGN: Prospective population-based cohort study. SETTING: Maternity Clinics, University Central Hospital, Helsinki, Finland. POPULATION: A total of 5180 unselected pregnant women. METHODS: Cervical swab samples were collected during the first and second trimester ultrasound screening. The concentration of IGFBP-1 was measured by immunoenzymometric assay, which detects the decidual phosphoisoforms of IGFBP-1 (phIGFBP-1). Concentrations of 10 micrograms/l or more were considered to be elevated. MAIN OUTCOME MEASURE: Spontaneous PTD. Results In the first trimester, 24.5% of women, and in the mid-second trimester, 20.2% of women, had an elevated cervical fluid phIGFBP-1 level. The rates of spontaneous PTD before 32 and before 37 weeks of gestation were higher in women with an elevated cervical fluid phIGFBP-1 level, compared with women who had cervical phIGFBP-1 of <10 micrograms/l (1.1% versus 0.3% and 5.7% versus 3.2%, respectively). An elevated phIGFBP-1 level in the first trimester was an independent predictor for PTD before 32 and before 37 weeks of gestation, with odds ratios of 3.0 (95% CI 1.3-7.0) and 1.6 (95% CI 1.2-2.3), respectively. Cervical phIGFBP-1 levels of 10 micrograms/l or more in the first trimester predicted PTD before 32 and before 37 weeks of gestation, with sensitivities of 53.8% and 37.0%, respectively. The negative predictive values were 99.7% and 96.8%. CONCLUSIONS: Elevated cervical fluid phIGFBP-1 levels in the first trimester were associated with an increased risk of spontaneous PTD.
Authors:
L Rahkonen; E-M Rutanen; M Nuutila; S Sainio; T Saisto; J Paavonen
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  117     ISSN:  1471-0528     ISO Abbreviation:  BJOG     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-08     Completed Date:  2010-06-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  England    
Other Details:
Languages:  eng     Pagination:  701-10     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynaecology, Helsinki University Hospital, Helsinki, Finland. leena.rahkonen@hus.fi
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Biological Markers / metabolism
Cervix Uteri / chemistry*,  cytology*
Decidua / chemistry*
Female
Humans
Insulin-Like Growth Factor Binding Protein 1 / metabolism*
Middle Aged
Obstetric Labor, Premature / metabolism,  prevention & control*
Pregnancy
Pregnancy Trimester, First
Pregnancy Trimester, Second
Prenatal Diagnosis / methods*
Prospective Studies
Risk Factors
Sensitivity and Specificity
Young Adult
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Insulin-Like Growth Factor Binding Protein 1

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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