Biochemical tissue-specific injury markers of the heart and brain in postpartum cord blood

• Published in: American journal of obstetrics and gynecology Vol. 200; no. 3; pp. 273.e1 - 273.e25
• Main Authors: Kocylowski, Rafal D., MD, Dubiel, Mariusz, MD, PhD, Gudmundsson, Saemundur, MD, PhD, Sieg, Ina, MD, Fritzer, Elfriede, Alkasi, Özkan, MD, Breborowicz, Gregory H., MD, PhD, von Kaisenberg, Constantin S., MD, PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.03.2009; Elsevier
• Subjects: Biological and medical sciences; Biomarkers - blood; Birth Weight; Body Weight; Brain Diseases - blood; Brain Diseases - congenital; Brain Diseases - diagnosis; cardiac defects; Cesarean Section; Chemistry, Clinical - standards; Clinical Medicine; Female; Fetal Blood - metabolism; Fetal Growth Retardation - blood; Fetal Growth Retardation - diagnosis; Gestational Age; Gynecology. Andrology. Obstetrics; Heart Defects, Congenital - blood; Heart Defects, Congenital - diagnosis; Hemolysis; Humans; Infant, Newborn; intrauterine growth restriction; Klinisk medicin; Male; Medical and Health Sciences; Medical sciences; Medicin och hälsovetenskap; Obstetrics and Gynecology; Obstetrics, Gynecology and Reproductive Medicine; Postpartum Period; Pregnancy; Prospective Studies; Reference Values; Reproduktionsmedicin och gynekologi; Sex Factors; Umbilical Arteries; umbilical cord blood; Umbilical Veins; intrauterine growth restriction; cardiac defects; umbilical cord blood; Heart; Brain; Tissue; Gynecology; Biochemistry; Marker; Puerperium; Obstetrics; Blood; Encephalon
• ISSN: 0002-9378; 1097-6868; 1097-6868
• DOI: 10.1016/j.ajog.2008.10.009

Objective We sought to establish references ranges and to test the hypothesis that biochemical tissue-specific markers for the heart in umbilical cord blood of newborns with cardiac defects and intrauterine growth restriction (IUGR) are abnormal. Study Design A prospective study was conducted. Serum samples of the umbilical vein (n = 280) and artery (n = 156) from 599 healthy newborns at 37+0 -42+0 weeks of gestation were collected. Total creatine kinase (CK), CK-MB heart type (CK-MB), cardiac troponin T (cTnT), myoglobin, N-terminal pro-B-type natriuretic peptide (NT-proBNP), and S100 were measured. Reference ranges for each marker were constructed. Concentrations of tissue-specific markers from umbilical cord blood of neonates with cardiac defects (n = 10) and IUGR (n = 41) were plotted against the established reference ranges. Results Reference ranges for each studied marker were established for both umbilical artery and vein. In fetuses with cardiac defects, both NT-proBNP (4/6 [66%] in the artery, 7/10 [70%] in the vein) and cTnT (2/10 [20%] in the vein) were increased. In fetuses with IUGR in the vein, NT-proBNP (10/41 [24%]) and cTnT (5/41 [12%]) were increased, whereas S100 (9/41 [21%]) was decreased. Conclusion In a subset of neonates with cardiac defects or growth restriction, irrespective of the pH at birth, tissue-specific injury markers for the heart in umbilical cord blood are abnormal.