Value of homocysteine levels, troponin I, and score for neonatal acute physiology and perinatal extension II as early predictors of morbidity.
BACKGROUND
Although the effects of cardiac troponin I (cTnI) have been documented in infants, the associations among the value of maternal and cord blood total homocysteine (Hcy) levels, cord blood cTnI and the score for neonatal acute physiology and perinatal extension II (SNAPPE-II) values in infants have not been documented. The aim of this study was to determine the value of maternal total Hcy (mtHcy) and cord blood total Hcy (ctHcy) levels, cTnI and SNAPPE-IIas predictive factors of morbidity in newborns.


METHODS
Maternal and cord blood samples were routinely collected for analysis from all prospective participating volunteers. In this case–control study, both hospitalized (n = 71) and non-hospitalized (n = 148) newborns were identified and followed until discharge.


RESULTS
Regression analysis revealed that pre-eclampsia, gestational age, mtHcy and SNAPPE-II values were significantly and independently associated with morbidity. Cord blood pH, ctHcy levels, SNAPPE-II values, and pre-eclampsia were associated with mtHcy levels. A similar association was found among cTnI, cord blood pH, mtHcy levels and ctHcy levels. The specificity and sensitivity values of mtHcy in predicting newborn morbidity were 62% and 78%, respectively,while the specificity and sensitivity values of SNAPPE-II in predicting newborn morbidity were 96% and 97%,respectively.


CONCLUSIONS
Elevated mtHcy levels were associated with cTnI, SNAPPE-II values, cord blood gas, and neonatal morbidities. These results suggest that SNAPPE-II may be an early predictor of morbidity after delivery and that elevated mtHcy levels may be an early prenatal biomarker of morbidity in newborns.
Department of Pediatrics Kocaeli University, Faculty of Medical, Kocaeli, Turkey
Hale
H
Usluer
Gulcan
G
Turker
Ayşe Sevim
AS
Gokalp
D018806:APACHE; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D007231:Infant, Newborn / Q000097:blood*; D007232:Infant, Newborn, Diseases / Q000097:blood / Q000175:diagnosis*; D007234:Infant, Premature / Q000097:blood; D008297:Male; D011225:Pre-Eclampsia / Q000097:blood; D011247:Pregnancy; D011379:Prognosis; D012372:ROC Curve; D012044:Regression Analysis; D019210:Troponin I / Q000097:blood*
D019210:Troponin I; D006710:Homocysteine