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


METHODS
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.


CONCLUSIONS
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.
Kocylowski
Rafal D
RD
Department of Obstetrics and Gynecology, Poznan University of Medical Sciences, Poznan, Poland.
Dubiel
Mariusz
M
Gudmundsson
Saemundur
S
Sieg
Ina
I
Fritzer
Elfriede
E
Alkasi
Ozkan
O
Breborowicz
Gregory H
GH
von Kaisenberg
Constantin S
CS
D015415:Biomarkers / Q000097:blood*; D001724:Birth Weight; D001835:Body Weight; D001927:Brain Diseases / Q000097:blood* / Q000151:congenital / Q000175:diagnosis; D002585:Cesarean Section; D002624:Chemistry, Clinical / Q000592:standards*; D005260:Female; D005312:Fetal Blood / Q000378:metabolism*; D005317:Fetal Growth Retardation / Q000097:blood* / Q000175:diagnosis; D005865:Gestational Age; D006330:Heart Defects, Congenital / Q000097:blood* / Q000175:diagnosis; D006461:Hemolysis; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D049590:Postpartum Period; D011247:Pregnancy; D011446:Prospective Studies; D012016:Reference Values; D012737:Sex Factors; D014469:Umbilical Arteries; D014471:Umbilical Veins
D015415:Biomarkers