title: Gender-specific differences in fetal cardiac troponin T in pregnancies complicated by placental insufficiency.
abstract: BACKGROUND
  Placental insufficiency and fetal growth restriction may lead to fetal hypoxia and acidemia, which result in fetal cardiac injury.
  
  
  OBJECTIVE
  The goal of this study was to compare the levels of fetal cardiac troponin T (cTnT) at birth and fetal Doppler parameters according to fetal gender in pregnancies complicated by placental insufficiency before 34 weeks' gestation.
  
  
  METHODS
  Between March 2007 and November 2010, singleton pregnancies with placental insufficiency characterized by abnormal umbilical artery Doppler results were prospectively studied. All the patients delivered by cesarean section, and Doppler examinations were performed up to 48 hours before birth. Immediately after delivery, umbilical artery blood samples were obtained for fetal cTnT measurements.
  
  
  RESULTS
  Fifty high-risk pregnant women met the study criteria. The study groups were as follows: group 1 consisted of 23 male fetuses (46%) and group 2 consisted of 27 female fetuses (54%). cTnT levels were significantly higher in the group of male fetuses (median, 0.14; range, 0.01-0.85) compared with the group of female fetuses (median, 0.05; range, 0.01-0.27) (P = 0.039). In the group of male fetuses, Doppler results of the ductus venosus assessment revealed values of pulsatility index for veins ≥1.0 in 15 male fetuses (65.2%) and 9 female fetuses (33.3%) (P = 0.032).
  
  
  CONCLUSIONS
  Fetal gender was associated with cTnT level at birth in pregnancies complicated by placental insufficiency before 34 weeks' gestation, although the Doppler findings did not support gender differences. The fetal cardiac compromise and cardiac injury may be influenced by fetal gender, suggesting differences in the cardiovascular response to fetal hypoxia.
authors.affiliation: Department of Obstetrics and Gynecology, São Paulo University Medical School, University of São Paulo, São Paulo, Brazil. roseli.nomura@hotmail.com
authors.forename: Roseli M Y
authors.initials: RM
authors.lastname: Nomura
authors.forename: Cristiane
authors.initials: C
authors.lastname: Ortigosa
authors.forename: Lílian R
authors.initials: LR
authors.lastname: Fiorelli
authors.forename: Adolfo W
authors.initials: AW
authors.lastname: Liao
authors.forename: Marcelo
authors.initials: M
authors.lastname: Zugaib
mesh_terms: D015415:Biomarkers / Q000097:blood; D005260:Female; D005311:Fetal Hypoxia / Q000097:blood* / Q000000981:diagnostic imaging*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010927:Placental Insufficiency / Q000097:blood* / Q000000981:diagnostic imaging*; D011247:Pregnancy; D011446:Prospective Studies; D011673:Pulsatile Flow; D012307:Risk Factors; D012737:Sex Factors; D020107:Troponin T / Q000097:blood*; D018617:Ultrasonography, Doppler, Pulsed; D016216:Ultrasonography, Prenatal / Q000379:methods
chemical_list: D015415:Biomarkers; D020107:Troponin T