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Evaluation of Predictive Value of Placental Alpha Microglobulin-1 Compared to Fetal Fibronectin in Symptomatic Preterm Delivery

Iraqi Postgraduate Medical Journal, 2022, Volume 21, Issue 3, Pages 318-325
10.52573/ipmj.2021.175795

Abstract

BACKGROUND:
Placental alpha microglobulin-1 (PAMG-1) is an important biomarker for the detection of preterm labor and premature rupture of fetal membrane, also fetal fibronectin leak observed into the vagina if                        a preterm delivery is likely to occur and can be measured by a screening test.
OBJECTIVE:
To compare the rapid bedside test for (placental alpha microglobulin-1) with the instrumented fetal fibronectin test for prediction of imminent spontaneous preterm delivery among women with symptoms of preterm labor.
PATIENT AND METHODS:
A prospective observational study, it included 86 pregnant women between 24 – 35 weeks of gestation with singleton pregnancy, viable fetus, intact membrane, and cervical dilatation ≤ 3 cm who attend to the labor room of the hospital complaining from signs and symptoms of spontaneous preterm labor.
Patients were tested for placental alpha microglobulin-1 with the instrumented fetal fibronectin test for prediction of imminent spontaneous preterm delivery.
RESULTS:
The positive predictive values for spontaneous preterm delivery within seven days for placental alpha microglobulin-1and fetal fibronectin were 25% (4/16) and 5.6% (2/36), respectively (P= 0.001 for placental alpha microglobulin-1 superiority), while the negative predictive values were 82.9% (58/70) and 72% (36/50) for placental alpha microglobulin-1 and fetal fibronectin, respectively (P= 0.02 for PAMG-1 superiority). The sensitivity and specificity of placental alpha microglobulin-1 were (25%, and 82.9% respectively), and of fetal fibronectin were (12.5%, and 51.4% respectively).
The PPVs for spontaneous preterm delivery within 14 days for placental alpha microglobulin-1 and fetal fibronectin were 43.8% (7/16) and 11.1% (4/36) respectively (P= 0.001 for placental alpha microglobulin-1 superiority), while the NPVs were 81.4% (57/70) and 68% (34/50) for placental alpha microglobulin-1 and FFN, respectively (P= 0.001 for placental alpha microglobulin-1 superiority).              The sensitivity and specificity of placental alpha microglobulin-1 were (35%, and 86.4% respectively), and of fetal fibronectin were (20%, and 51.6% respectively).
CONCLUSION:
Placental alpha microglobulin-1 performed the same as fetal fibronectin in ruling out spontaneous preterm delivery among contemporary cohort of symptomatic women but demonstrated statistical superiority in predicting it.
 
Keywords:

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