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
Abstract
BACKGROUND

A twin pregnancy can carry greater risks than singleton pregnancies. About 60 in 100 twin pregnancies result in spontaneous birth before 37 wk, which is associated with several complications in the premature babies. Clinical detection of biomarkers may help to predict the possibility of premature birth so that corresponding interventions can be given to the pregnant women in a timely manner, in order to reduce the risk of preterm birth and improve the outcomes of the newborn infants.

AIM

To explore the clinical value of transvaginal ultrasound measurement of cervical length combined with insulin-like growth factor binding protein-1 (IGFBP-1) hyperphosphorylation in cervical secretions as predictors of preterm delivery in twin pregnancies.

METHODS

A total of 254 pregnant women with twin pregnancies, who were admitted to Hainan General Hospital and underwent maternity examination, were selected as the study subjects from January 2015 to December 2018. All participants received transvaginal ultrasound measurement of cervical length and phosphorylated IGFBP-1 (phIGFBP-1) test between 24 and 34 wk gestation. The pregnancy outcomes were analyzed.

RESULTS

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

CONCLUSION

Cervical length combined with phIGFBP-1 tests is of value for the prediction of outcomes of preterm delivery in twin pregnancies.

Keywords: Hyperphosphorylated insulin-like growth factor binding protein-1, Cervical length, Ultrasound, Twin pregnancies, Preterm delivery

Core Tip: This study analyzed the efficacy and feasibility of transvaginal ultrasound measurement of cervical length combined with the phosphorylated insulin-like growth factor binding protein-1 (IGFBP-1) test for the prediction of preterm birth in twin pregnancies. The accuracy of the detection was high. In pregnant women with shorter central length, those with positive phosphorylated IGFBP-1 expression had a higher preterm delivery rate than those with negative expression. In pregnant women with longer central length, the effects of phosphorylated IGFBP-1 are weak on preterm delivery.