Early prognostic significance of umbilical cord troponin I in critically ill newborns. Prospective study with a control group (original) (raw)

2000, Journal of Perinatal Medicine

To determine the value of cord blood cardiac troponin I levels (cTnI) as an early prognostic factor in critically ill newborns, and to compare cord cTnI levels with the prognostic value of the score for neonatal acute physiology (SNAP). Methods: Cord arterial samples were collected routinely for blood gas analysis, and cord venous samples for cTnI and cardiac-specific creatine kinase assay. The study group (ns109) comprised critically ill newborns who required mechanical ventilation. The control group (ns96) comprised newborns who were either completely healthy (ns48) or were followed in a level I neonatal care unit due to moderate-severity problems. Results: The critically ill newborns had significantly higher cTnI levels than control babies (median wmin-maxx 1.4 w0-13x vs. 0 w0-1.8x ng/mL, respectively; P-0.001). In critically ill newborns, non-survivors had significantly higher cTnI levels than survivors (median wmin-maxx 6.6 w1.3-13.0x vs. 1.3 w0-8.0x ng/mL, respectively; P-0.001). Receiver-operator curve analysis revealed that, compared with SNAP, cTnI was a more sensitive predictor of mortality in critically ill newborns (area under curves0.96; 95% CIs0.90-1.02). Conclusion: Significantly elevated cord cTnI may be a valuable predictor of mortality in critically ill newborns.