Biochemical tissue-specific injury markers of the heart and brain in postpartum cord blood

Kocyłowski, Rafał; Dubiel, Mariusz; Gudmundsson, Sæmundur; Sieg, I; Fritzer, Elfriede; Alkasi, Oezkan; Breborowicz, G H; Kaisenberg, Constantin S. von

doi:10.1016/j.ajog.2008.10.009

Cited by 52 publications

(62 citation statements)

References 35 publications

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“…decreased right-ventricular output, followed by diastolic dysfunction and cardiac compromise (16); a significant correlation of nt-proBNP and early markers of cardiac dysfunction in fetal growth restriction was found (17)(18)(19). Cardiac malformations have the potential to alter loading conditions during fetal life; increased levels of circulating nt-proBNP have been detected in fetal and umbilical cord blood samples (19,20).…”

Section: Discussionmentioning

confidence: 99%

“…Cardiac malformations have the potential to alter loading conditions during fetal life; increased levels of circulating nt-proBNP have been detected in fetal and umbilical cord blood samples (19,20). Concentrations were highest in cases with left-or right-ventricular outflow tract obstructions with intact ventricular septum; the associated rise in ventricular wall tension was assumed to be a potent stimulus for nt-proBNP secretion (21).…”

Section: Discussionmentioning

confidence: 99%

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Circulating N-terminal pro-B-type natriuretic peptide in fetal anemia before and after treatment

et al. 2012

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Background: N-terminal pro-B-type natriuretic peptide (ntproBNP) is an established marker of heart failure in adult cardiology. We analyzed nt-proBNP in the circulation of fetuses with increased volume load secondary to anemia and investigated the effect of treatment on nt-proBNP concentration. Methods: Fetuses undergoing intrauterine transfusion (IUT) were examined. nt-proBNP was measured before IUT and correlated with hemoglobin concentrations, ultrasonographic findings, and Doppler measurements of the peak systolic velocity of the middle cerebral artery (Mca-PsV). Results: a total of 27 patients (7 with hydrops) and 78 controls were examined. nt-proBNP was markedly elevated in anemia (P < 0.001). concentrations were highest in hydropic fetuses (P < 0.03); no differences were present in hemoglobin and Mca-PsV values between hydropic and nonhydropic cases. In fetuses undergoing multiple IUTs nt-proBNP normalized after the third IUT, whereas hemoglobin and Mca-PsV remained abnormal. Conclusion: Levels of circulating nt-proBNP correlate well with the degree of myocardial workload in the hyperdynamic state of fetal anemia. We hypothesize that normalization of nt-proBNP after serial transfusions is an indicator of myocardial adjustment to chronic anemia. nt-proBNP measurement may be useful in the management of fetal anemia, particularly in cases at risk of hydrops and fetuses requiring multiple transfusions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Circulating N-terminal pro-B-type natriuretic peptide in fetal anemia before and after treatment

et al. 2012

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“…The decrease in free fatty acids impacts on the fetus since they are major components of the cell membrane and a source of energy for fetal development and growth [41]. In addition, it has been reported that in fetuses with cardiac defects and IUGR, the levels of troponine T in umbilical venous blood are increased by 12% and 20%, respectively [42]. Nevertheless, unlike what has been observed in our study, other authors have reported that AST values in UCB from newborns affected by IUGR were not different from those observed in normal newborns; even lower ALT values have been described in newborns with IUGR with respect to normal newborns, which suggests that the reduced activity may be due to hepatic immaturity of the newborn to produce enzymes [43].…”

Section: Discussionmentioning

confidence: 99%

Biochemical Profiling Study in Umbilical Cord Blood as Predictors of Neonatal Damage

Gruccio¹

2014

Int J Clin Pediatr

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Background: During pregnancy inflammatory, metabolic and immunologic disorders that affect differently the fetus, are known. These could be early disorders: abortion, intrauterine growth retardation, low birth weight and neonatal death; or late disorders: cardiovascular and metabolic disease in adults. The objective was to analyze different biochemical parameters in maternal venous blood and newborn's umbilical cord blood (UCB) from healthy and pathological mothers for early detection of future perinatal complications. Methods:Maternal venous blood (283) and UCB (283) were analyzed. The patients were consecutively, prospectively and transversally studied. Delivery: cesarean section. Mothers and newborns were classified: control group (C) (n = 99) and pathological group (P) (n = 184). Glucose, urea, creatinine, uric acid (UA), bilirubin (Bi), proteins (PT), albumin (Alb), transaminases (ALT/AST), alkaline phosphatase, gamma-glutamyl transpeptidase (GGT), creatinkinasa (CK), lactate dehydrogenase (LDH), iron, calcium, phosphorus, magnesium, sodium, potassium (K), chlorine, cholesterol (Chol), triglycerides (TG) and hsCRP were determined by recommended methods. Student's t and Mann-Whitney tests were applied, P < 0.05.Results: P newborns from P mothers showed significant decrease: in gestation weeks (GW) and newborn weight (NW) with respect to C newborns from C mothers (P < 0.001); significant increases in Chol, TG, UA, K, Bi, AST and GGT (P: 0.01, < 0.001, 0.03, < 0.001, 0.04, < 0.001, < 0.001, respectively) and significant decreases in CK, PT and Alb (P < 0.001). P mothers showed significant increase in UA, ALT, AST, GGT (P: 0.04, 0.02, 0.04, < 0.001, respectively) with respect to C mothers. Conclusions:The decrease in GW and NW in P newborns with respect to C would be related to intrauterine growth restriction (IUGR) accompanying these disorders; increases in Chol, TG, UA, K, Bi, AST and GGT would be related to cellular destruction associated to maternal disorders and deficit in pulmonary development by IUGR respectively, whereas decreases in CK, PT and Alb to IUGR. Increase in UA, ALT, AST and GGT from P mothers with respect to C would be associated to inflammatory process with liver alterations. A future study including greater number of samples and analysis of each maternal disorder is proposed to obtain early markers of neonatal damage and to prevent future perinatal complications.

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“…The only one study reported 97.5 th percentile upper reference limit of NT-proBNP and TnT from healthy neonates, according to the CLSI guideline [21,63]. In uterus, hemodynamics between placenta and fetal heart can vary with gestational age [64,65], and reference intervals for cardiac biomarkers in neonates could be diferent from those in adults.…”

Section: Cardiac Biomarkersmentioning

confidence: 99%

Reference Intervals of Platelets, Lymphocytes and Cardiac Biomarkers in Umbilical Cord Blood

Kim¹,

Hur²,

Moon³

et al. 2017

Umbilical Cord Blood Banking for Clinical Application and Regenerative Medicine

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The umbilical cord blood (UCB) can be used for early detection of neonatal diseases. The UCB can be used for early detection of neonatal diseases. Establishing reference intervals is essential for appropriate interpretation of results of laboratory tests using UCB and for correct medical decisions of pediatricians and neonatologists. The use of proper reference intervals provides reliable information to pediatricians and neonatologists; thus, they could make correct medical decisions for neonates. This chapter discussed reference intervals of platelets, lymphocytes, and cardiac biomarkers in UCB according to the Clinical Laboratory Standards Institute guidelines. Except iatrogenic anemia, thrombocytopenia is the most common hematologic abnormality in neonates. Immature platelet fraction is a novel parameter to estimate megakaryopoiesis and can be useful to understand the mechanism of thrombocytopenia, platelet destruction or bone marrow failure, in neonates. Lymphocyte counts, T cell and B cell, can relect status of immune system in fetus and neonates. Especially Tregs in UCB may contribute to maintain the immune homeostasis in the feto-maternal relationship, and the presence of Tregs would be essential to prevent immune dysregulation in fetus and neonates. Congenital heart disease or defect is the most common birth defect in newborns. Cardiac biomarkers are essential to evaluate heart function and to give information of myocardial injury, necrosis, or myocardial stretch. There are no current guidelines for their routine use in children.

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Biochemical tissue-specific injury markers of the heart and brain in postpartum cord blood

Cited by 52 publications

References 35 publications

Circulating N-terminal pro-B-type natriuretic peptide in fetal anemia before and after treatment

Circulating N-terminal pro-B-type natriuretic peptide in fetal anemia before and after treatment

Biochemical Profiling Study in Umbilical Cord Blood as Predictors of Neonatal Damage

Reference Intervals of Platelets, Lymphocytes and Cardiac Biomarkers in Umbilical Cord Blood

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