ArticleAJOG global reports2026
Predictive value of uterocervical angle combined with phosphorylated insulin-like growth factor binding protein-1 testing for preterm delivery and adverse neonatal outcomes.
Article in AJOG global reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPreterm birth is a leading cause of perinatal morbidity. While transvaginal cervical length (CL) is the standard screening tool for symptomatic women, its low specificity frequently leads to overtreatment and unnecessary hospital admissions. Although the uterocervical angle (UCA) and phosphorylated insulin-like growth factor binding protein-1 (phIGFBP-1) are recognized as strong independent predictors, the clinical value of integrating these biomechanical and biochemical markers into a single triage model remains unclear.
objectiveTo investigate the predictive accuracy of a combined model incorporating UCA, CL, and the phIGFBP-1 test for spontaneous preterm delivery, and to evaluate its clinical utility and association with neonatal outcomes. STUDY
designA cohort study was conducted on 130 pregnant women presenting with symptoms of threatened preterm labor. The latency period (time-to-delivery) was analyzed using Kaplan-Meier survival curves and a multivariable Cox proportional hazards regression model. Diagnostic accuracy was compared utilizing receiver operating characteristic curves. Clinical utility was evaluated by the number of preventable hospitalization days, and neonatal outcomes were compared based on the phIGFBP-1 test results.
resultsThe combined predictive model significantly improved diagnostic accuracy, achieving an excellent area under the curve of 0.776 compared to 0.731 for CL alone (
conclusionIntegrating the UCA and the biochemical marker (phIGFBP-1) provides superior predictive accuracy for preterm delivery compared to the traditional CL measurement. This protocol not only optimizes healthcare resource allocation by safely reducing unnecessary hospitalizations but also effectively identifies pregnancies at risk for adverse neonatal outcomes. More importantly, it empowers physicians to confidently triage low-risk groups, thereby restricting medication overuse, minimizing unnecessary admission rates, and mitigating the economic burden on both families and the healthcare system.
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