Key result
Small-for-gestational-age newborns had a higher rate of detectable cardiac troponin I in umbilical cord blood at birth compared to appropriate-for-gestational-age infants (4.2% vs 0%; p=0.007).
Why the study?
Do small-for-gestational-age neonates have higher rates of detectable cardiac troponin I at birth compared to appropriate-for-gestational-age neonates?
Observational (n=381)
Do small-for-gestational-age neonates have higher rates of detectable cardiac troponin I at birth compared to appropriate-for-gestational-age neonates?
Absolute Event Rate: 4.2% vs 0%
p-value: p=0.007
A small subset of small-for-gestational-age neonates exhibits detectable cardiac troponin I at birth, suggesting subclinical in utero myocardial injury.
Detectable cord troponin in SGA neonates may indicate subclinical injury; hypothesis-generating and should not yet change practice.
OBJECTIVE: Small-for-gestational-age (SGA) infants are at risk for premature death from cardiovascular disease (myocardial infarction and stroke), hypertension, and diabetes in adult life. Severe intrauterine growth restriction is often associated with subclinical cardiovascular abnormalities detectable during fetal echocardiography. The objective of this study was to determine whether SGA newborns have evidence of myocardial injury at birth. STUDY DESIGN: Cardiac troponin I, a specific marker of myocardial injury widely used for the diagnosis of myocardial infarction in adults, was determined in umbilical cord blood. Umbilical cord venous blood was obtained at the time of birth from 72 SGA newborns (birth weight below the 10th centile for gestational age) and 309 newborns whose birth weights were appropriate for gestational age (AGA). Cardiac troponin I was determined with a commercially available immunoassay (sensitivity 0.2 ng/ml) employed in clinical laboratories (Immulite 2000, Diagnostic Products Corp., Los Angeles, CA). RESULTS: Cardiac troponin I was not detectable in any of the blood samples from AGA infants. In contrast, 4.2% (3/72) of SGA infants had detectable cardiac troponin I in umbilical cord blood (Fisher's exact test, p = 0.007). CONCLUSION: A subgroup of SGA newborns undergoes myocardial injury before birth. This insult may predispose to the development of adult premature cardiovascular disease and death.
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Chaiworapongsa et al. (2002) conducted an observational in Small-for-gestational-age (SGA) neonates (n=381). Small-for-gestational-age (SGA) vs. Appropriate for gestational age (AGA) was evaluated on Detectable cardiac troponin I in umbilical cord blood (p=0.007). Small-for-gestational-age newborns had a higher rate of detectable cardiac troponin I in umbilical cord blood at birth compared to appropriate-for-gestational-age infants (4.2% vs 0%; p=0.007).
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