J. Perinat. Med. 2017; aop George Uchenna Eleje*, Euzebus Chinonye Ezugwu, Ahizechukwu Chigoziem Eke, Lydia Ijeoma Eleje, Joseph Ifeanyichukwu Ikechebelu, Ifeanyichukwu Uzoma Ezebialu, Chukwudi Celestine Obiora, Betrand Obi Nwosu, Chukwuemeka Okwudili Ezeama, Gerald Okanandu Udigwe, Charles Ikechukwu Okafor and Frank Okechukwu Ezugwu Accuracy of a combined insulin-like growth factor-binding protein-1/interleukin-6 test (Premaquick) in predicting delivery in women with threatened preterm labor DOI 10.1515/jpm-2016-0339 Received October 24, 2016. Accepted January 17, 2017. Abstract Purpose: To determine values of combinations of inter- leukin-6 (IL-6)/cervical native insulin-like growth factor- binding protein-1 (IGFBP-1)/total IGFBP-1 (Premaquick © ) in predicting spontaneous deliveries and spontaneous exclusive preterm deliveries in women with threatened preterm labor. Methods: Women with singleton pregnancies between gestation age (GA) of 24 weeks and 36 weeks and 6 days with preterm labor were recruited during a prospective multicenter study. Premaquick © was positive when at least two of three biomarkers were positive. Sensitivity, speci- ficity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were estimated for both predic- tion of spontaneous deliveries and spontaneous exclusive preterm deliveries. Results: Ninety-seven (99.0%) out of 98 women enrolled were analyzed. Based on delivery status 7/14 days post- enrollment of general study population, Premaquick © had a sensitivity of 87.1/85.7%, a specificity of 92.4/96.8%, a PPV of 84.4/93.8% and a NPV of 93.9/92.3% for prediction of spontaneous delivery. Predictive accuracy of Premaquick © test in relation to days of enrollment were: 90.7% ( ≤ 7 days) and 92.8% ( ≤ 14 days). For women enrolled at GA < 35 weeks, Premaquick © had a sensitivity of 100.0/87.5%, a specificity of 94.1/96.9%, a PPV of 70.5/87.5%, a NPV of 100.0/96.9% and an accuracy of 95.0/95.0% for predic- tion of preterm delivery within 7/14 days of enrollment, respectively. PPV was most significantly different in both groups when outcomes were compared between 2 days and 14 days post-enrollment (P < 0.001). Conclusion: This novel triple biomarker model of native and total IGFBP-1 and IL-6 appears to be an accurate test in predicting spontaneous deliveries and spontaneous exclusive preterm deliveries in threatened preterm labor in singleton pregnancies. Keywords: Accuracy; IGFBP-1; IL-6; Premaquick; threat- ened preterm labor. Introduction Prematurity arising from preterm delivery has remained the major contributor to neonatal morbidity and mortality *Corresponding author: Dr. George Uchenna Eleje, Effective Care Research Unit, Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Nnewi Campus, P.M.B. 5025, Nnewi, Anambra State, Nigeria, Tel.: + 2348068117444, E-mail: georgel21@yahoo.com; and Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, PMB. 5025, Nnewi, Nigeria Euzebus Chinonye Ezugwu: Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Enugu State, Nigeria Ahizechukwu Chigoziem Eke: Division of Maternal Fetal Medicine, Obstetrics and Gynecology, John Hopkins University School of Medicine, 600 N Wolfe Street, Phipps 228, Baltimore, MD, USA Lydia Ijeoma Eleje: Measurement and Evaluation Unit, Department of Educational Foundations, Nnamdi Azikiwe University, Awka, Nigeria Joseph Ifeanyichukwu Ikechebelu, Chukwuemeka Okwudili Ezeama and Gerald Okanandu Udigwe: Effective Care Research Unit, Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Nnewi Campus, Nigeria; and Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, PMB 5025, Nnewi, Nigeria Ifeanyichukwu Uzoma Ezebialu: Department of Obstetrics and Gynecology, Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka, Nigeria Chukwudi Celestine Obiora and Frank Okechukwu Ezugwu: Department of Obstetrics and Gynecology, ESUT Teaching Hospital, Parklane, Enugu, Nigeria Betrand Obi Nwosu and Charles Ikechukwu Okafor: Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, PMB 5025, Nnewi, Nigeria; and Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Nnewi Campus, PMB 5025, Nnewi, Nigeria Brought to you by | Washington University in St. Louis Authenticated Download Date | 2/28/17 9:13 PM