Rapid cervical phIGFBP-1 test in asymptomatic twin pregnancies is inefficient in predicting preterm delivery prior to 34 gestational weeks.

OBJECTIVES: To assess the effectiveness of a rapid second trimester test for cervical phIGFBP-1 in the prediction of sponta-neous preterm delivery prior to 34 weeks in asymptomatic twin pregnancies.

MATERIAL AND METHODS: A prospective observational study conducted on 232 twin pregnancies tested for phIGFBP-1 at 20-24 weeks of gestation. 151 patients assessed as asymptomatic, with cervical length > 25 mm at 20-24 weeks were analysed. The primary outcome was the delivery < 34 weeks of gestation.

RESULTS: The spontaneous preterm delivery before completing 34 weeks occurred in 23 patients (15.2%), including 9 in dichorionic and 14 in monochorionic pregnancies. The sensitivity of phIGFBP-1 test was 0.39 and specificity 0.63 in predicting delivery before 34 gestational weeks. phIGFBP-1 had a low positive predictive value of 0.16 and high negative predictive value (0.85). Both positive and negative predictive values of delivery < 34 weeks were close to 1.

CONCLUSIONS: A test for phIGFBP1 presence is not an effective additional tool for predicting preterm delivery before 34 weeks in twin gestation.