Abstract
Objective
Cardiac troponin-I is a known biomarker of myocardial injury in adults and children
but its diagnostic utility is unclear in newborns.
This study aimed to establish normative data for troponin-I in stable newborns and
assess any variation due to maternal diabetes status, mode of delivery, and Apgar
scores.
Study Design
Prospective, observational study of stable newborn ≥35 weeks gestation admitted to
a well-baby nursery at a single institution. Infants with respiratory distress, congenital
infections, malformations, or syndromes were excluded. Troponin-I values were obtained
by a validated point-of-care capillary blood sample at 24 hours of age.
Results
A total of 132 patients were included for analysis. Thirteen infants were born to
mothers with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during pregnancy
and analyzed as a subgroup, with the remaining 119 infants comprising the base cohort
to establish baseline normative troponin-I levels in stable newborn infants. The mean
(standard deviation) troponin-I level of infants in the base cohort group was 0.019 ± 0.018 ng/mL
and in infants born with maternal SARS-CoV-2 infection during pregnancy troponin-I
level was 0.081 ± 0.1 ng/mL (p < 0.001). In infants of the base cohort, there was no significant difference in troponin-I
levels between diabetic versus nondiabetic mothers, vaginal birth versus cesarean
section, and 5-minute Apgar score of <7 versus ≥7.
Conclusion
Cardiac troponin-I level in healthy term newborns was 0.019 ± 0.018 ng/mL, which conforms
to healthy children and adult lab values. There was no statistically significant difference
in troponin-I levels in infants of maternal diabetes or normal glucose status, mode
of delivery, cesarean versus vaginal, or 5-minute Apgar score of <7 or ≥7. Troponin-I
levels in asymptomatic neonates born to mothers with a history of SARS-CoV-2 during
pregnancy demonstrated an elevation when compared to the baseline group of infants.
Key Points
-
Troponin‐I level, biomarker of myocardial injury, in newborns not requiring delivery‐room.
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Resuscitation is comparable to normal pediatric & adult population independent of
mode of delivery or maternal diabetes status.
Keywords
cardiac troponin-I - stable newborn infant - myocardial injury biomarker - maternal
COVID
