Case Control Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 26, 2021; 9(18): 4553-4558
Published online Jun 26, 2021. doi: 10.12998/wjcc.v9.i18.4553
Significance of highly phosphorylated insulin-like growth factor binding protein-1 and cervical length for prediction of preterm delivery in twin pregnancies
Rui-Hong Lan, Jie Song, Hu-Min Gong, Yang Yang, Hong Yang, Lin-Mei Zheng
Rui-Hong Lan, Jie Song, Hu-Min Gong, Yang Yang, Hong Yang, Lin-Mei Zheng, Department of Obstetrics, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou 570311, Hainan Province, China
Author contributions: Lan RH and Zheng LM the designed this study; Lan RH wrote the manuscript; Lan RH, Song J, Gong HM, Yang Y, Yang H, and Zheng LM contributed to the data collection; All authors proofread the revised manuscript.
Institutional review board statement: The study was approved by the Ethics Committee of Hainan General Hospital.
Informed consent statement: All patients gave informed consent.
Conflict-of-interest statement: No conflict of interest.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hu-Min Gong, MM, Chief Physician, Department of Obstetrics, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, No. 19 Xiuhua Road, Xiuying District, Haikou 570311, Hainan Province, China. 15595895588@163.com
Received: January 16, 2021
Peer-review started: January 16, 2021
First decision: January 24, 2021
Revised: February 22, 2021
Accepted: March 4, 2021
Article in press: March 4, 2021
Published online: June 26, 2021
ARTICLE HIGHLIGHTS
Research background

Twins are at higher risk of preterm labor and delivery. As a result of being born too early, twins may be born with a higher risk of complications. Detection should be performed in pregnant women to reduce the risk of preterm birth.

Research motivation

Transvaginal ultrasound measurement of cervical length phosphorylated insulin-like growth factor binding protein-1 (phIGFBP-1) test were two approaches used for the prediction of preterm birth. This study researched the accuracy of these two tests in determining the chances of preterm birth occurrence.

Research objectives

This study studied the feasibility of cervical length and phIGFBP-1 test for the prediction of preterm birth in twin pregnancy.

Research methods

A total of 254 pregnant women with twin pregnancies were included in the study. Transvaginal ultrasound measurement of cervical length and the phIGFBP-1 test were performed on all of the participants. The test results were compared with the actual pregnancy outcomes of these women and the relevant data were analyzed.

Research results

In women with a positive phIGFBP-1 test result, preterm birth rate was higher in those with cervical length ≤ 25 mm than those with cervical length > 25 mm (all P < 0.05). Moreover, in women with a negative phIGFBP-1 test result, preterm birth rate was higher in women with cervical length ≤ 25 mm than those whose cervical length > 25 mm (all P < 0.05). The sensitivity, specificity, positive predict value and negative predictive values of phIGFBP-1 test combined with cervical length were 95.71%, 91.21%, 95.12% and 92.22%, respectively, for the prediction of preterm birth.

Research conclusions

Transvaginal ultrasound measurement of cervical length combined with the phIGFBP-1 test may effectively predict the possibility of preterm birth in twin pregnancy.

Research perspectives

Detection of multiple biochemical indices may help to predict preterm birth and reduce the risk in twin pregnancies. Larger studies are warranted to further discuss the accuracy of these biochemical indices and to reduce the screening test-associated harms to mothers and their babies.