Evaluation of cord blood creatine kinase (CK), cardiac troponin T (cTnT), N-terminal-pro-B-type natriuretic peptide (NT-proBNP), and s100B levels in nonreassuring foetal heart rate.

Aim: To evaluate the possible associations between creatine kinase (CK), cardiac troponin T (cTnT), N-terminal-pro-B-type natriuretic peptide (NT-proBNP), and s100B levels in umbilical cord blood and nonstress test results, cord-blood gas analyses and Apgar scores.

Material And Methods: A total of 93 cesarean section deliveries after 34 + 0/7 gestational week (GW) were evaluated. The study ( = 50) and control ( = 43) groups consisted of type III and type I nonstress test (NST) according to the 2008 National Institute of Child Health and Human Development workshop report on electronic fetal monitoring. The serum levels of ProBNP II, S100-B, CK-MB, and cTnT were measured in cord blood and were evaluated according to the NST results, cord-blood gas analyses (pH and base-excess values) and 1- and 5-minute Apgar scores. Exclusion criteria for both groups included congenital abnormalities, multiple pregnancy, chorioamnionitis, oligohydramnios, polyhydramnios, intrauterine growth retardation (IUGR), and placental abruption.

Results: Mean age, weight, height, gestational age, and birth weight were comparable in type I and III NST groups. 1- and 5- minute Apgar, umbilical artery and vein pH values, and base deficiency were significantly lower in type III NST group compared to the type I NST group. The serum 100B (1616 ± 119 versus 533 ± 95 ng/L,  < .001), CK-MB (28.67 ± 21.17 versus 14.20 ± 11.26 ng/L,  < .001), cTnT (657 ± 396 versus 230 ± 132 ng/L,  < .001) and proBNP (1727 ± 379 versus 1069 ± 721 ng/L, < .001) levels were significantly elevated in the NST type III compared to the NST type I group. The serum 100B, CK-MB, cTnT and proBNP levels were significantly elevated in the cord pH < 7.00 ( = 10) compared to pH = 7.00-7.15 group ( = 18). The serum 100B and proBNP were significantly elevated in the cord pH = 7.00-7.15 compared to the pH > 7.15 group ( = 65), whereas serum cTnT and proBNP levels were comparable in the latter two groups. In the study group, S100B, cTnT, and proBNP had negative correlations with 1- and 5-minute Apgar scores. All of the four markers showed negative correlations with A. umbilicalis pH and base excess.

Conclusions: Mean S100B, CK-MB, cTnT, and NT-proBNP were significantly higher in the study group compared to the control group. The serum 100B, CK-MB, cTnT, and proBNP levels were significantly elevated in the cord pH < 7.00 compared to pH = 7.00-7.15 group. The serum 100B and proBNP were significantly elevated in the cord pH = 7.00-7.15 compared to the pH > 7.15 group.