A study of troponin I levels in asphyxiated neonates and its use as an early predictor of short-term outcome

Background: Perinatal asphyxia remains a major cause of global mortality, contributing to almost one quarter of the world’s 3 million neonatal deaths and almost half of 2.6 million third-trimester stillbirths. Troponin I levels are higher in neonates with perinatal asphyxia, especially in those with myocardial dysfunction, and it can be used as an early predictor of short-term outcome. Aims and Objectives: The aim of the study was to study the troponin I level in asphyxiated neonate and its use as an early predictor of short-term outcome. Materials and Methods: The neonate who fulfilled the inclusion criteria based on cord blood gases was recruited as the study group, while neonates with normal parameters were enrolled for comparison. Cardiac troponin I level venous sample was collected within 6 h of life from both asphyxiated and non-asphyxiated neonates, and the sample was sent to the laboratory immediately in an icepack. Troponin I normal range is 0.0–0.3 ng/mL. Troponin I level above the 0.3 ng/mL is considered positive. Results: Among 50 asphyxiated and 50 control neonates, 38 out of 50 (76%) asphyxiated neonates had elevated levels of troponin I, and 5 out of 50 (10%) healthy control neonates had elevated troponin I levels. P-value (<0.0001) showed that troponin I levels were higher among asphyxiated neonate then healthy neonates. A total of 13 (26%) neonates in the case group were expired out of 50. All expired neonates had elevated levels of troponin I levels that means troponin I levels could predict short term outcome of morbidities and mortalities in asphyxiated neonates. Conclusion: Measuring Troponin I levels within the first 6 h of life showed statistically significant correlation with morbidity and mortality in the presence of shock and need for inotropic support.