Cardiac troponin T in cord blood
S J Clarka, P Newlandb, C W Yoxallc, N V Subhedarc
a University of
Liverpool, Liverpool, UK, b Royal
Liverpool Children's Hospital, Liverpool, c Liverpool Women's Hospital
Correspondence to: Dr Clark, Neonatal Unit, Liverpool Women's Hospital, Crown Street, Liverpool L8 7SS, UK rvecho{at}yahoo.com
Accepted 17 August
2000
BACKGROUND
Perinatal
asphyxia is associated with cardiac dysfunction. This may be secondary
to myocardial ischaemia. Cardiac troponin T is the ideal marker for
myocardial necrosis. Elevated levels in cord blood may be associated
with intrauterine hypoxia and increased perinatal morbidity.
AIMSTo establish an
upper limit of normal for cardiac troponin T concentration in the cord
blood of infants. Relations between cardiac troponin T levels and other
variables were investigated.
METHODSCord blood
samples were collected from 242 infants and analysed. Data on
gestation, birth weight, sex, Apgar scores, respiratory status, and
mode of delivery were recorded.
RESULTSA total of 242 samples were collected, and 215 samples from infants without
respiratory distress were used to establish the 95th percentile of
0.050 ng/ml. The gestation of these infants ranged from 31 to 42 weeks
and birth weight ranged from 1.4 to 5 kg. There were no relations
between cardiac troponin T levels and the other variables in these
healthy infants. Twenty seven infants developed respiratory symptoms
requiring oxygen and/or ventilation. These infants had significantly
higher cord cardiac troponin T levels than their healthy counterparts
(median (interquartile range) 0.031 (0.010-0.084)
v 0.010 (0.010-0.014) ng/ml respectively; p < 0.001).
CONCLUSIONSCardiac
troponin T levels in the cord blood are unaffected by gestation, birth
weight, sex, or mode of delivery. Infants with respiratory distress had
significantly higher cord cardiac troponin T levels, suggesting that
cardiac troponin T may be a useful marker for myocardial damage in neonates.
Keywords: newborn; cord blood; cardiac troponin T; heart; myocardial damage
© 2001 by Archives of Disease in Childhood
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