Objective: This study aimed to assess the accuracy of a second-trimester rapid cervical phosphorylated insulin-like growth factor binding protein-1 (phIGFBP-1) test to predict spontaneous preterm delivery in asymptomatic twin pregnancies. Method: During the second trimester, a rapid test to detect phIGFBP-1 in cervical secretions was performed on consecutive twin pregnancies between 2009 and 2011, to evaluate its predictive value for spontaneous preterm delivery at <28, <30, <32 and <34weeks' gestation. Excluded were patients with cerclage, pessary or undergoing indicated preterm delivery. Results: A total of 197 pregnancies fulfilled the study criteria and were tested at a median gestational age of 20.3weeks (interquartile range: 20-20.6). Median gestational age at delivery was 36.4weeks. Spontaneous preterm delivery at <34weeks occurred in 21 (10.7%) cases, at <32weeks in 9 (4.5%), at <30weeks in 6 (3%) and at <28weeks in 4 (2%). Seventeen patients (8.7%) were test positive: In this group, three patients delivered before 34weeks' gestation, whereas none delivered at <32weeks. The sensitivity, specificity, positive and negative predictive value of the test for spontaneous preterm delivery <34weeks were 14% (95% confidence interval, 3-37%), 92% (86-95%), 17% (4-44%) and 90% (84-93%), respectively, with a positive and negative likelihood ratio of 1.79 (0.56-5.74) and 0.93 (0.78-1.10). Conclusions: In the second trimester, rapid cervical phIGFBP-1 testing in asymptomatic twin pregnancies has a poor performance in predicting spontaneous preterm delivery.
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