Cord Blood Cardiac Troponin T and Troponin I Levels in Multiple-Gestation Neonates

Abstract

The increased mortality and morbidity rates in multiple-gestation neonates are not completely understood. Troponin measurements have a role in situations where the evaluation of the cardiac damage is difficult, such as in cases of unexplained intrauterine fetal growth restriction or death. These conditions, along with perinatal hypoxic risk and in utero ischemic damage, are frequently found in multiple gestations. In this context, a myocardial damage could be expected more frequently in multiple than in singleton births. We hypothesized that cord blood cardiac troponin T and troponin I, markers of myocardial damage, could be different between singleton and multiple pregnancies and, among twins, between the first- and the second-born twin. Troponins T and I and creatine kinase MB concentrations were not increased in twins at birth and were not different between the first- and the second-born twin. These data suggest that myocardial damage, evaluated by cardiac troponin T, troponin I, and creatine kinase MB measurements, does not seem to be a relevant problem in multiple-gestation neonates.

Cord Blood Cardiac Troponin I as an Early Predictor of Short-Term Outcome in Perinatal Hypoxia

“…Similar to Trevisanuto et al [10], we found cTnI levels !1 ng/ml in the cord blood, 3rd and 7th day serum of healthy newborns similar to healthy adults. Studies about cTnI levels in neonates is limited [10,11,[33][34][35]. Engin et al [35] found increased cord cTnI levels in newborns with maternal hypertensive disorders, magnesium sulfate exposure and preterm delivery.…”

“…Trevisanuto et al [10] studied cord blood cTnI and cTnT in healthy newborns and they found undetectable levels as adults. A recent study [11] investigated elevation of cTnT and cTnI in multiple-gestation neonates as possible indicators of myocardial damage to detect ischemia in utero. The results showed normal levels of both of these proteins in twins at birth and no difference was found between the first-and the second-born twins.…”

Troponin in Newborns and Pediatric Patients

“…These conditions are frequently found in multiple gestations. However, in previous study troponins T and I and creatine kinase MB concentrations were not increased in twins at birth and were not different between the first-and the second-born twin [41]. These data suggested that myocardial damage, evaluated by cardiac troponin T, troponin I, and creatine kinase MB measurements, does not seem to be a relevant problem in multiple-gestation neonates.…”

Cardiac injury biomarkers in paediatric age: Are we there yet?

“…In multiple gestations, troponins T and I and CK-MB were not increased in twins at birth and were not different between the first-and the second-born twin [62]. In intrauterine growth restriction that implies foetal hypoxia, resulting in flow redistribution and sparing of vital organs, no differences in troponin I levels were observed between the appropriate-for-gestational-age and intrauterine growth restriction groups [63].…”