Abstract
Objective This study was aimed to establish a reference interval for high-sensitivity cardiac
troponin I (hs-cTnI) in umbilical cord blood of infants and to assess its association
with the risk of predetermined early neonatal outcomes in a high-acuity tertiary care
hospital.
Study Design Umbilical cord-blood samples were collected and hs-cTnI was measured in all infants
born between August 2015 and September 2015 at McMaster Children's Hospital (n = 256). Gestational age, birth weight, Apgar's scores, age in days at which feeding
was established, neonatal intensive care unit (NICU) admission, and discharge in days
after birth were recorded.
Results The 90th, 95th, and 99th percentiles for the term infant subcohort were 19.75, 41.45,
and 166.30 ng/L, respectively. We observed decreased mean gestational ages and birth
weights in both the 90th (37.7 weeks; 2,961.4 g) and 95th percentiles (37.1 weeks;
2,709.9 g) when compared with the remaining infants. Moreover, levels of hs-cTnI were
significantly higher in infants with respiratory distress requiring intervention (p < 0.05), low birth weight infants (p < 0.01), preterm infants (p < 0.001), and those requiring NICU admission (p < 0.01). Multiple linear regression of the recorded demographic factors revealed
prematurity (gestational age <35 weeks: coefficient 0.346 ± 0.160, p < 0.05; gestational age <37 weeks: coefficient 0.253 ± 0.105, p < 0.05) and male sex (coefficient 0.138 ± 0.047; p < 0.01) to be most predictive of log-hs-cTnI levels.
Conclusion This study establishes the reference values for cord-blood hs-cTnI in infants at
a tertiary care center. Premature and sick infants requiring NICU admission had significantly
higher levels of hs-cTnI.
Key Points
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Established the 90th, 95th, and 99th percentiles of neonatal cord-blood hs-cTnI in
term infants as 19.75, 41.45, and 166.30 ng/L, respectively.
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Infants with hs-cTnI levels exceeding the 90th percentile had lower gestational ages
and birth weights with higher rates of NICU admissions.
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Infants with respiratory distress or requiring NICU admission were found to have higher
levels of hs-cTnI.
Keywords
neonatal - umbilical cord blood - high-sensitivity troponin I - reference interval
