Comparison of PAMG-1 and phIGFBP-1 Tests for the Prediction of Preterm Delivery in Patients with Preterm Labor
Journal
Open Journal of Obstetrics and Gynecology
Date Issued
2017
Author(s)
Josephine Theresia Maier
Hanns Helmer
Lars Hellmeyer
DOI
10.4236/ojog.2017.73037
Abstract
Objective: To compare PAMG-1 and phIGFBP-1 tests in predicting impending spontaneous preterm delivery within 7 days upon presentation in pregnant women with symptoms of preterm labor. Study Design: From September 2014 to April 2015 women with singleton gestation, symptoms of preterm labor, GA 22 - 35, participated in this prospective cohort study upon admission. Recruited patients had intact membranes and a minimal cervical dilatation of ≤3 cm. Vaginal swabs for phIGFBP-1 and PAMG-1 were taken in addition to routine treatment. Biochemical test results were blinded and had no effect on management of patients. Results: A total of 96 patients were
screened for inclusion into the trial; 57 met the inclusion criteria for final
analysis. The PAMG-1 test was positive in 5.7% of patients, while phIGFBP-1
test was positive in 29.8% of patients. The prediction of spontaneous preterm
delivery within 7 days of admission in patients with a cervical length < 25 mm
(30%), the PAMG-1 test and phIGFBP-1 test showed a SN of 100% and 100%;
SP of 83.3% and 50.0%, (p ≤ 0.05); PPV of 71.4% and 45.5%; and NPV of
100% and 100%. 89.5% of women who received corticosteroids and 84.2% of
women who received tocolysis did not go into preterm labor within one week.
Conclusion: Our study supports the high negative predictability of biochemical tests to rule out spontaneous preterm labor in patients with a short cervix.
However, our study strongly suggests that the PAMG-1 test is more accurate
for predicting imminent spontaneous preterm delivery as compared to
phIGFBP-1. These findings can significantly reduce economic burden caused
by unnecessary admission and treatment of patients suspected of preterm labor. Such a reduction in the use of corticosteroids and tocolytics would lead to
a reduction in the short and long term health effects associated with the use of
therapeutic drugs like corticosteroids, antibiotics and tocolytics.
screened for inclusion into the trial; 57 met the inclusion criteria for final
analysis. The PAMG-1 test was positive in 5.7% of patients, while phIGFBP-1
test was positive in 29.8% of patients. The prediction of spontaneous preterm
delivery within 7 days of admission in patients with a cervical length < 25 mm
(30%), the PAMG-1 test and phIGFBP-1 test showed a SN of 100% and 100%;
SP of 83.3% and 50.0%, (p ≤ 0.05); PPV of 71.4% and 45.5%; and NPV of
100% and 100%. 89.5% of women who received corticosteroids and 84.2% of
women who received tocolysis did not go into preterm labor within one week.
Conclusion: Our study supports the high negative predictability of biochemical tests to rule out spontaneous preterm labor in patients with a short cervix.
However, our study strongly suggests that the PAMG-1 test is more accurate
for predicting imminent spontaneous preterm delivery as compared to
phIGFBP-1. These findings can significantly reduce economic burden caused
by unnecessary admission and treatment of patients suspected of preterm labor. Such a reduction in the use of corticosteroids and tocolytics would lead to
a reduction in the short and long term health effects associated with the use of
therapeutic drugs like corticosteroids, antibiotics and tocolytics.
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Open Journal of Obstetrics and Gynecology, 2017, 7, 358-368
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