Cardiac troponin T in cord blood

Background-Perinatal asphyxia is associated with cardiac dysfunction. This may be secondary to myocardial ischaemia. Cardiac troponin T is the ideal m arker for myocardial necrosis. Elevated levels in cord blood may be associa ted with intrauterine hypoxia and increased perinatal morbidity. Aims-To establish an upper limit of normal for cardiac troponin T concentra tion in the cord blood of infants. Relations between cardiac troponin T lev els and other variables were investigated. Methods-Cord blood samples were collected from 242 infants and analysed. Da ta on gestation, birth weight, sex, Apgar scores, respiratory status, and m ode of delivery were recorded. Results-A 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 card iac troponin T levels and the other variables in these healthy infants. Twe nty seven infants developed respiratory symptoms requiring oxygen and/or ve ntilation. These infants had significantly higher cord cardiac troponin T l evels 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). Conclusions-Cardiac troponin T levels in the cord blood are unaffected by g estation, birth weight, sex, or mode of delivery. Infants with respiratory distress had significantly higher cord cardiac troponin T levels, suggestin g that cardiac troponin T may be a useful marker for myocardial damage in n eonates.