Early midtrimester serum insulin-like factors and cervical length to predict preterm delivery

ObjectiveTo investigate which ultrasound findings or serum biomarkers, including insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 1 and 3 (IGFBP-1 and IGFBP-3, respectively), in the first and early second trimesters are the best predictors for preterm delivery.Materials and MethodsThis was a case–control study conducted between March 2011 and March 2013 with women presenting for routine antenatal care at 11–18 weeks. We collected serum samples from pregnant women and stored them at −80°C. All patients underwent cervical length (CL) measurement at 18–21 weeks. We retrieved frozen samples for analysis from women with subsequent preterm and term delivery. Prediction models were developed using multivariate stepwise logistic regression. Receiver-operating characteristics curves were used to determine the most useful cutoff point.ResultsOf the 72 women recruited, 24 women underwent spontaneous preterm delivery, and 48 women with term delivery were randomly selected as the control group, in a 1:2 ratio. The maternal serum concentration of IGFBP-3 and CL were significantly associated with preterm birth.ConclusionAmong the various known ultrasound findings and serum biomarkers in the early midtrimester, only CL and IGFBP-3 are independent predictors for preterm delivery in asymptomatic women.