Department of Pediatrics, University Hospital Liège, Belgium.
Department of Pediatrics, University Hospital Liège, Belgium.
Early Hum Dev. 2019 Oct;137:104826. doi: 10.1016/j.earlhumdev.2019.104826. Epub 2019 Jul 27.
Early diagnosis of perinatal asphyxia, the major cause of neonatal mortality and morbidity, might be improved by the detection of neonatal stress biomarkers such as cardiac troponin (CTn)T, CTnI, NT-Terminal-pro-Brain Natriuretic Peptide (NT-pro-BNP), copeptin, and high sensitivity C-reactive protein (hs-CRP). However, reference values in neonates are lacking. The objective of our study was therefore to establish a reference range of these biomarkers in healthy full term newborns and to analyze the influence of delivery mode on their cord blood concentrations.
CTnT, CTnI, NT-pro-BNP, Copeptin and hs-CRP levels were determined in 201 neonates enrolled in this prospective study and correlated to the delivery mode and post-natal outcome.
Using the 99th percentile, the upper reference limit in healthy newborns was established for all biomarkers. Neonates born after complicated delivery had significantly higher values of CTnT, CTnI and Copeptin than those born after uncomplicated delivery. In the multiple regression models with CTnT as dependent variable, the delivery mode was the statistically significant independent variable.
In this study, we established reference values of cord blood concentrations of cardiac stress biomarkers in healthy newborns. We showed that cardiac-related birth stress is dependent on delivery mode.
围产期窒息是新生儿死亡和发病的主要原因，如果能通过检测心脏肌钙蛋白（cTn）T、cTnI、N 端脑利钠肽前体（NT-pro-BNP）、 copeptin 和高敏 C 反应蛋白（hs-CRP）等新生儿应激生物标志物，或许可以提高围产期窒息的早期诊断水平。然而，目前尚缺乏新生儿的参考值。因此，我们的研究目的是建立健康足月新生儿这些生物标志物的参考范围，并分析分娩方式对其脐血浓度的影响。
本前瞻性研究纳入了 201 名新生儿，检测了他们的 cTnT、cTnI、NT-pro-BNP、copeptin 和 hs-CRP 水平，并将其与分娩方式和产后结局相关联。
使用第 99 个百分位数，我们为所有生物标志物建立了健康新生儿的上参考限值。与无并发症分娩的新生儿相比，有复杂分娩史的新生儿的 cTnT、cTnI 和 copeptin 值显著更高。在以 cTnT 为因变量的多元回归模型中，分娩方式是统计学上显著的独立变量。
在这项研究中，我们建立了健康新生儿脐血中心脏应激生物标志物浓度的参考值。我们表明，与心脏相关的出生应激与分娩方式有关。
