Cardiac troponin T as a marker of myocardial injury in a group of asphyxiated African neonates

Background: In caucasian newborns, troponin T (cTnT) is a specific marker for myocardial injury in perinatal asphyxia. This is the first such study in negroid neonates. Aims: To evaluate myocardial injury in a group of asphyxiated African newborns and determine the influence of mode of delivery on cTnT levels. Methods: Serum cTnT and clinical parameters in 40 asphyxiated and 40 healthy negroid neonatal controls were measured within the first 72 hours of life by chemiluminescence immune-assay. Perinatal asphyxia was assessed by APGAR score. The infants were followed up until discharge or death. Results: Mean (SD) cTnT values were significantly higher in asphyxiated infants [0.03 (0.04) ng/ml] than in healthy controls [0.01 (0.006) ng/ml, P=0.002]. Asphyxiated infants delivered by forceps and vacuum extraction had significantly higher levels of cTnT [0.04 (0.018) ng/ml] than those born by caesarian section [0.02 (0.008) ng/ml] and by normal delivery [0.03 (0.01) ng/ml, P=0.003]. cTnT levels were higher in infants who died (P=0.037). Conclusion: In the asphyxiated infants, mean cTnT levels were significantly higher than in controls. They were also significantly higher in those born by vacuum and forceps delivery and asphyxiated infants who died.