Department of Pediatrics, McMaster Children's Hospital, Hamilton, Ontario, Canada.
Brookfield School of Medicine and Health Sciences, University College Cork, Cork, Ireland.
Am J Perinatol. 2022 Oct;29(14):1548-1554. doi: 10.1055/s-0041-1722944. Epub 2021 Feb 6.
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.
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 ( 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.
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 ( < 0.05), low birth weight infants ( < 0.01), preterm infants ( < 0.001), and those requiring NICU admission ( < 0.01). Multiple linear regression of the recorded demographic factors revealed prematurity (gestational age <35 weeks: coefficient 0.346 ± 0.160, < 0.05; gestational age <37 weeks: coefficient 0.253 ± 0.105, < 0.05) and male sex (coefficient 0.138 ± 0.047; < 0.01) to be most predictive of log-hs-cTnI levels.
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.
· 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.. · Infants with hs-cTnI levels exceeding the 90th percentile had lower gestational ages and birth weights with higher rates of NICU admissions.. · Infants with respiratory distress or requiring NICU admission were found to have higher levels of hs-cTnI..
本研究旨在建立高敏心肌肌钙蛋白 I（hs-cTnI）在婴儿脐血中的参考区间，并评估其与高风险三级保健医院新生儿早期预定结局的风险之间的关系。
收集 2015 年 8 月至 2015 年 9 月期间在麦克马斯特儿童医院出生的所有婴儿的脐血样本，并测量 hs-cTnI。记录胎龄、出生体重、阿普加评分、开始喂养的天数、新生儿重症监护病房（NICU）入院和出生后出院天数。
足月婴儿亚组的第 90、95 和 99 百分位数分别为 19.75、41.45 和 166.30ng/L。与其余婴儿相比，第 90 百分位数（37.7 周；2961.4g）和第 95 百分位数（37.1 周；2709.9g）的平均胎龄和出生体重均较低。此外，需要干预的呼吸窘迫婴儿（ <0.05）、低出生体重婴儿（ <0.01）、早产儿（ <0.001）和需要入住 NICU 的婴儿（ <0.01）的 hs-cTnI 水平显著升高。记录的人口统计学因素的多元线性回归显示，早产（胎龄<35 周：系数 0.346±0.160， <0.05；胎龄<37 周：系数 0.253±0.105， <0.05）和男性（系数 0.138±0.047； <0.01）是预测 log-hs-cTnI 水平的最主要因素。
本研究在三级保健中心建立了脐带血 hs-cTnI 的参考值。需要入住 NICU 的早产儿和患病婴儿的 hs-cTnI 水平显著升高。
· 建立了足月新生儿脐带血 hs-cTnI 的第 90、95 和 99 百分位数分别为 19.75、41.45 和 166.30ng/L。
· hs-cTnI 水平超过第 90 百分位数的婴儿胎龄和出生体重较低，NICU 入院率较高。
· 有呼吸窘迫或需要 NICU 入院的婴儿 hs-cTnI 水平较高。
