Biochemical tests for predicting preterm labor

Background. Preterm labor (PL) is the leading cause of perinatal morbidity and mortality in the world. Objective. Comparison of PL prediction accuracy using placental α-microglobulin-1 (PAMG-1) test and phosphorylated insulin-like growth factor-binding protein (PHIGFBP-1) test. Methods. A comparative, prospective observational study included 49 women with symptoms of threatened PL gestational age from 20/0 to 36/6 weeks, cervical length <30mm and a whole fetal bladder. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) for the PAMG-1 and FPSIF-1 test systems were determined, and the time of onset of labor for ≤7 days and ≤14 days based on the above parameters was estimated. Results. The PHIGFBP-1 test was positive in 10 (20.4%) women, the PAMG-1 test - in 4 (8.2%). PL occurred within 7 days in 5 (10.2%) women. The sensitivity of the PAMG-1 and PHIGFBP-1 tests was 60 and 60%, the specificity was 97.7 and 84.1% (p=0.031), the PPV was 75 and 30%, and the NPV was 95.6 and 94.9% respectively. Within 14 days, PL occurred in 7 (14.3%) women. Sensitivity - 57 and 57%, specificity - 100 and 85.7% (p=0.031), PPV - 100 and 40%, NPV - 93.3 and 92.3% for PAMG-1 and PHIGFBP-1, respectively. There was no PL In women with a cervical length of 25-29 mm. Conclusion. The PAMG-1 test is the best predictor of spontaneous PL for 7 and 14 days than the PHIGFBP-1 test. However, for the widespread introduction of PAMG-1 testing in clinical practice, larger studies are required.

preterm labor, placental a-microglobulin-1 (PAMG-1), phosphorylated insulin-like growth factor-binding protein (PHIGFBP-1), cervical length, fetal fibronectin