The Differences of Cord Blood Troponin I (TnI) Level between Normal and Asphyxiated Infants and Its Correlation with APGAR Score

Abstract

Asphyxia could increase infant morbidity and mortality. Ante-and intrapartum cardiotocography (CTG) examination could lead to a false positive diagnosis of asphyxia (fetal distress). Troponin I (TnI) is an important factor to the pathogenesis of asphyxia. Cord blood TnI level is increased in infants with fetal cardiac dysfunction, causing pathological CTG and low APGAR score (<7). In the future, TnI is expected to reduce false positive diagnosis of asphyxia caused by CTG. This research was conducted to examine and analyze the differences of cord blood TnI level between normal and asphyxiated infants and to determine the correlation between TnI level and APGAR score. An observational analytical cross sectional study was conducted to a total of 36 patients with asphyxiated infants (18 patients) and normal infants (18 patients). Subjects were selected according to the inclusion and exclusion criteria. Cardiotocography, TnI level, and APGAR score were examined. Umbilical cord blood samples were taken from each subject for the measurement of TnI level using a highly sensitive indirect sandwich Enzyme Linked Immunosorbent Assay (ELISA). Statistical analysis was performed by Mann-Whitney and Rank Spearman correlation coefficient test. Cord blood TnI level of asphyxia and normal groups were 1615.77 ± 1199.98 pg/mL and 819.88 ± 145.82 pg/mL respectively (p ≤ 0.05). Rank Spearman correlation coefficient between cord blood TnI level and 1' and 5' APGAR score was −0.523 (p = 0.026; p ≤ 0.05) and −0.502 respectively (p = 0.034; p ≤ 0.05). There was a statistically significant difference between cord blood TnI level of asphyxia and normal groups; cord blood TnI level of asphyxia group was higher than normal group. Furthermore, negative correlation was observed between cord blood TnI level and APGAR score. A. Siddiq et al.955