Correlation of troponin I with perinatal and neonatal outcomes in neonates with respiratory distress.

Background: The specific aims of the present study were to evaluate the associations between cardiac troponin I (Tn I) and perinatal events and whether Tn I serves as a predictor to evaluate neonatal outcomes.

Methods: Tn I level was assessed in sick neonates with respiratory distress within 12 h after birth. Apgar scores, acidosis, ventilator or oxygen requirement, hospital days and placenta clues were recorded. A total of 80 sick neonates were enrolled (54 preterm and 26 full-term neonates) delivered at Shin-Kong Wu Ho-Su Memorial Hospital between July 2003 and December 2004.

Results: There was a significant negative correlation between Apgar scores at 1 min and 5 min (r=-0.383, P= 0.001; r=-0.500, P < 0.001), acidosis (r=-0.309, P= 0.006), base excess (r=-0.332, P= 0.003) and Tn I. The subjects were divided into two groups using the median level of 0.028 ng/mL as a cut-off. There were significantly fewer neonates with high Apgar score (>7 at 5 min; 27/40, 69.2% vs 38/40, 97.4%; P= 0.001) in the higher Tn I group (> or =0.028 ng/mL). Lower pH (7.4 +/- 0.10 vs 7.3 +/- 0.1, P= 0.011), lower base excess (-1.0 +/- 4.3 vs -4.4 +/- 5.1, P= 0.003) and less placental weight (548.8 +/- 195.36 g vs 396.56 +/- 154.30 g, P= 0.019) were also seen in the higher Tn I group.

Conclusion: Tn I may play a role in the assessment of perinatal outcomes but is not a precise predictor of neonatal outcomes. Tn I level of 0.028 ng/mL is also suggested as a predictor of severity of perinatal outcomes in neonates with respiratory distress.