Am J Perinatol 2004; 21(3): 147-152
DOI: 10.1055/s-2004-823775
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Fetal Cardiac Troponin I in Relation to Intrapartum Events and Umbilical Artery pH

Fionnuala McAuliffe1 , Katrina Mears1 , Sean Fleming2 , Helen Grimes3 , John J. Morrison1
  • 1Department of Obstetrics and Gynaecology, University Hospital Galway, Galway, Ireland
  • 2Department of Cardiology, University Hospital Galway, Galway, Ireland
  • 3Department of Biochemistry, University Hospital Galway, Galway, Ireland
Further Information

Publication History

Publication Date:
14 April 2004 (online)

The objective of this study was to measure fetal cardiac troponin I in umbilical artery blood in relation to intrapartum events and umbilical artery pH. Umbilical artery blood samples were obtained after delivery from 110 infants and cardiac troponin I was measured. The onset of labor, mode of delivery, presence of meconium, and umbilical artery pH were examined in relation to cardiac troponin I. The median cardiac troponin I level was 0.03 ng/mL (range, 0.03 to 0.881 ng/mL). Neonates with a cardiac troponin I level above the normal range had a lower umbilical artery pH when compared with those neonates with a normal cardiac troponin I level (p = 0.005). No relationship between the following parameters and cardiac troponin I was observed: gestational age, parity, presence of labor, meconium staining, mode of delivery, birth weight, and Apgar scores. Fetal cardiac troponin I shows little variation at birth. Increased levels of cardiac troponin I are associated with a lower umbilical artery pH.

REFERENCES

  • 1 Perri S V. The regulation of contractile activity in muscle.  Biochem Soc Trans. 1979;  7 593-617
  • 2 Bodor G S, Porterfield D, Voss E M et al.. Cardiac troponin I is not expressed in fetal and healthy or diseased adult human skeletal muscle tissue.  Clin Chem. 1995;  41 1710-1715
  • 3 Trinquier S, Flecheux O, Bullenger M, Castex F. Highly specific immunoassay for cardiac troponin I assessed in noninfarct patients with chronic renal failure or severe polytrauma.  Clin Chem. 1995;  41 1675-1676
  • 4 Apple F S, Falahati A, Paulson P R et al.. Improved detection of minor ischaemic myocardial injury with measurement of serum cardiac troponin I.  Clin Chem. 1997;  43 2047-2051
  • 5 Missov E, Calzolari C, Davy J M, Leclercq R, Rossi M, Pau B. Cardiac troponin I in patients with haematologic malignancies.  Coron Artery Dis. 1997;  8 537-541
  • 6 Fleming S M, O'Gorman T, O'Byrne L, Grimes H, Daly K, Morrison J J. Cardiac troponin I and N-terminal pro-brain natriuretic peptide in umbilical artery blood in relation to fetal heart rate abnormalities during labor.  Pediatr Cardiol. 2001;  22 393-396
  • 7 Quivers E S, Murphy J N, Soldin S J. The effect of gestational age, birth weight, and disease on troponin I and creatine kinase MB in the first year of life.  Clin Biochem. 1999;  32 419-421
  • 8 Soldin S J, Murthy J N, Agarwalla P K, Ojeifo O, Chea J. Pediatric reference ranges for creatine kinase, CKMK, troponin I, iron, and cortisol.  Clin Biochem. 1999;  32 77-80
  • 9 Christenson R H, Apple F S, Morgan D L et al.. Cardiac troponin I measurements with the ACCESS immunoassay system: analytical and clinical performance characteristics.  Clin Chem. 1998;  44 52-60
  • 10 Hamm C W, Goldman B U, Heeschen C et al.. Emergency room triage of patients with acute chest pain by means of rapid testing for cardiac troponin I.  N Engl J Med. 1997;  337 1648-1653
  • 11 Panteghini M, Bonora R, Pagani F et al.. Rapid, highly sensitive immunoassay for determination of cardiac troponin I in patients with myocardial cell damage.  Clin Chem. 1997;  43 1464-1465
  • 12 Giuliani I, Bertinchant J, Granier C et al.. Determinants of cardiac troponin I forms in the blood of patients with acute myocardial infarction and patients receiving crystalloid or cold blood cardioplegia.  Clin Chem. 1999;  45 213-222
  • 13 Immer F F, Stocker F, Seiler A M et al.. Troponin I for prediction of early postoperative course after pediatric cardiac surgery.  J Am Coll Cardiol. 1999;  33 1719-1723
  • 14 Montegomery V L, Sullivan J E, Buchino J J. Prognostic value of pre- and postoperative cardiac troponin I measurement in children having cardiac surgery.  Pediatr Dev Pathol. 2000;  3 53-60
  • 15 Bodor G S, Survant L, Voss E, Smith S, Porterfield D, Apple F. Cardiac troponin T composition in normal and regenerating human skeletal muscle.  Clin Chem. 1997;  43 476-484
  • 16 Trevisanuto D, Lachin M, Zaninotto M et al.. Cardiac troponin T in newborn infants with transient myocardial ischaemia.  Biol Neonate. 1998;  73 161-165
  • 17 Clark S J, Newland P, Yoxall C W, Subhedar N V. Cardiac troponin T in cord blood.  Arch Dis Child Fetal Neonatal Ed. 2001;  84 F34-F37
  • 18 Makikallio K, Vuolteenaho O, Jouppila P, Rasanen J. Association of severe placental insufficiency and systemic venous pressure rise in the fetus with increased neonatal cardiac troponin T levels.  Am J Obstet Gynecol. 2000;  183 726-731
  • 19 Adamcova M, Kokstein Z, Palicka V, Vavrova J, Podholova M, Kostal M. Cardiac troponin T in neonates after acute and long-term tocolysis.  Biol Neonate. 2000;  78 288-292
  • 20 Shelton S, Fouse B L, Holleman C M, Sedor F A, Herbert W NP. Cardiac troponin T levels in umbilical cord blood.  Am J Obstet Gynecol. 1999;  181 1259-1262
  • 21 Narin N, Cetin N, Kilic H et al.. Diagnostic value of troponin T in neonates of mild pre-eclamptic mothers.  Biol Neonate. 1999;  75 137-142
  • 22 Moller J C, Thielson B, Schaible T F et al.. Value of myocardial hypoxia markers (creatine kinase and its MB fraction, troponin T, QT-intervals) and serum creatinine for the retrospective diagnosis of perinatal asphyxia.  Biol Neonate. 1998;  73 367-374
  • 23 Martin-Ancel A, Garcia-Alix A, Gaya F, Cabanas F, Burgueros M, Quero J. Multiple organ involvement in perinatal asphyxia.  J Pediatr. 1995;  127 786-793
  • 24 Primhak R A, Jedeikin R, Ellis G et al.. Myocardial ischaemia in asphyxia neonatorum. Electrocardiographic, enzymatic and histological correlations.  Acta Paediatr Scand. 1985;  74 595-600
  • 25 Barberi I, Calabro M P, Cordaro S et al.. Myocardial ischaemia in neonates with perinatal asphyxia. Electrocardiographic, echocardiographic and enzymatic correlations.  Eur J Pediatr. 1999;  158 742-747

Fionnuala McAuliffeM.D. 

Department of Obstetrics and Gynaecology, Mount Sinai Hospital

700 University Avenue

Toronto, Ontario, Canada M5G 1Z5

    >