Second-trimester Maternal Serum Insulin-like Growth Factor Binding Protein 4 to Sex Hormone-binding Globulin Ratio as a Predictor of Spontaneous Preterm Birth: A Prospective Observation Study from North India
Rekha Sachan, Shikha Sharma, Radhey Shyam, Munna Lal Patel, Wahid AliAbstract
Background:
The ratio of maternal serum insulin-like growth factor binding protein 4 (IGFBP-4) to sex hormone-binding globulin (SHBG) has emerged as a promising proteomic predictor, but validation in high-burden settings including India is limited. The aim of this study was to evaluate the predictive value of the second-trimester IGFBP-4/SHBG ratio for spontaneous preterm birth (PTB) and association with fetomaternal outcome.
Methods:
A prospective observational study was carried out over a period of 1 year. A total of 190 singleton pregnant women between 16 and 21 weeks of gestation were enrolled. Maternal serum IGFBP-4 and SHBG levels were measured by enzyme-linked immunosorbent assay (ELISA) technique using an ELISA kit as per the producer protocol. Participants were followed till delivery and categorized into Group A preterm (delivery <37 weeks,
Results:
The PTB rate was 28.4%, and the second-trimester IGFBP-4/SHBG ratio was significantly higher in Group A than Group B (0.619 ± 0.399 vs. 0.191 ± 0.242;
Conclusion:
The second-trimester maternal serum IGFBP-4/SHBG ratio is a highly sensitive and specific predictor for spontaneous PTB. It also correlates strongly with adverse neonatal outcomes.