A study on umbilical cord blood cardiac troponin T as an early predictor of myocardial ischaemia in perinatal asphyxiated newborns

Abstract

Objectives: To predict the occurrence of myocardial ischaemia in the first 72 hours of life in perinatal asphyxiated newborns by estimating cord blood cardiac troponin T. Method: Fifty newborns with Apgar scores ≤ 6 at 5 minutes of birth from October 2012 to October 2014 were included in the study. Cord blood samples of those babies were taken for estimation of cardiac troponin T (cTnT) by the Immunoassay Elecsys Troponin T STAT (Roche) method. Umbilical cord blood cTnT level above 0.097ng/ml was considered as positive. Further, those newborns were managed in the neonatal intensive care unit (NICU) according to severity and monitored for hypotension with requirement of inotropes. In the next 72 hours those who required inotropes were screened for myocardial ischaemia by electrocardiogram (ECG) and echocardiogram (ECHO). Results: Out of the 50 cases, 45 developed myocardial ischaemia and cord blood was positive for cTnT in 40 cases which was statistically very significant ( p = 0.0001). Further, when comparison was done between Group A (moderate asphyxia) and Group B (severe asphyxia), there was no statistical significance (p = 0.57). Conclusions: Irrespective of the severity of perinatal asphyxia, cord blood cTnT >0.09ng/ml will help to predict occurrence of myocardial ischaemia in the first 72 hours of life in perinatal asphyxiated newborns. Sri Lanka Journal of Child Health, 2019 ; 48 (2): 152- 154