A study by Sisti et al. found serum concentrations of insulin-like growth factor-binding protein 1 (IGFBP-1) in twin pregnancies prior to 20-week gestation to be significantly higher in cases prior to the development of PPROM, suggesting its potential role in early prediction of PPROM in this specific clinical scenario [50]. This evidence concerns the gene IGFBP1 and preterm premature rupture of the membranes.