Pediatric Clinic, Clinical Centre Kragujevac, Kragujevac, Serbia

Aleksandra M. Simović; Jovan Lj. Košutić; Sergej M. Prijić; Jasmina B. Knežević; Ana J. Vujić; Nadežda D. Stojanović

doi:10.2298/1780

Aleksandra M. Simović Pediatric Clinic, Clinical Centre Kragujevac, Kragujevac, Serbia; Faculty of Medicine, University of Kragujevac, Kragujevac, Serbia
Jovan Lj. Košutić Mother and Child Health Care Institute “Dr Vukan Čupić”, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Sergej M. Prijić Mother and Child Health Care Institute “Dr Vukan Čupić”, Belgrade, Serbia
Jasmina B. Knežević Pediatric Clinic, Clinical Centre Kragujevac, Kragujevac, Serbia; Faculty of Medicine, University of Kragujevac, Kragujevac, Serbia
Ana J. Vujić Pediatric Clinic, Clinical Centre Kragujevac, Kragujevac, Serbia; Faculty of Medicine, University of Kragujevac, Kragujevac, Serbia
Nadežda D. Stojanović Pediatric Clinic, Clinical Centre Kragujevac, Kragujevac, Serbia

DOI: https://doi.org/10.2298/1780

Keywords: perinatology, asphyxia, biological markers, heart failure, troponin I, sensitivity and specificity,

Abstract

Background/Aim. In recent years, the focus of interest of the scientific community is the application of heart markers as early indicators and prognostic parameters of perinatal asphyxia (PA). The aim of this study was to evaluate the significance of clinical application of heart markers in term newborns with perinatal asphyxia. Methods. During a 3-year period we analyzed 91 full-term newborns (55 with and 36 without perinatal asphyxia). In all the subjects within the first 24–48 h after birth, we simultaneously determined serum concentrations of cardiac troponin I, brain natriuretic peptide, MB fraction of creatine kinase (CK-MB) and C-reactive protein. Results. In the group of full-term neonates with PA significantly higher levels of cardiac troponinI (p = 0.000), CK-MB fraction (p = 0.000), brain natriuretic peptide (p = 0.003) and C-reactive protein (p = 0.017) were found, compared to the group of healthy full-term newborns. In merged group (n = 91) cardiac troponin I level correlated with the fifth minute Apgar score (r = -0.637, p = 0.000) and the serum lactate concentration in the first 12h after birth (r = 0.529, p = 0.000). Early increase in cardiac troponin I > 0.135 µg/L predicted the risk of death with the sensitivity of 84.6% and specificity of 85.9%, while the increase in CK-MB fraction, brain natriuretic peptide and C-reactive protein did not have a predictive value with respect to a mortality outcome. Conclusion. Among the tested cardiac markers, cardiac troponin I is the most sensitive and the only reliable early predictor of mortality in full-term neonates with perinatal asphyxia.

Author Biographies

Aleksandra M. Simović, Pediatric Clinic, Clinical Centre Kragujevac, Kragujevac, Serbia; Faculty of Medicine, University of Kragujevac, Kragujevac, Serbia

Chief of UIC, Centre of neonatology, Pediatric Clinic, Clinical Centre Kragujevac, Kragujevac, Serbia

Ass. of paediatrics, Faculty of Medicine, University of Kragujevac, Kragujevac, Serbia

Centre of neonatology,Pediatric Clinic, Clinical Centre Kragujevac, Kragujevac, Serbia

Jovan Lj. Košutić, Mother and Child Health Care Institute “Dr Vukan Čupić”, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia

Consultant paediatric cardiologist, Mother and Child Health Care Institute “Dr Vukan Cupic”, Belgrade

Associate professor of pediatrics, Faculty of Medicine, University of Belgrade

Sergej M. Prijić, Mother and Child Health Care Institute “Dr Vukan Čupić”, Belgrade, Serbia

Paediatric cardiologist, Mother and Child Health Care Institute “Dr Vukan Cupic”, Belgrade

Jasmina B. Knežević, Pediatric Clinic, Clinical Centre Kragujevac, Kragujevac, Serbia; Faculty of Medicine, University of Kragujevac, Kragujevac, Serbia

Full professor of pediatrics, Faculty of Medicine, University of Kragujevac

Chief of Departement of cardiology, Pediatric Clinic, Clinical Centre Kragujevac, Kragujevac, Serbia

Ana J. Vujić, Pediatric Clinic, Clinical Centre Kragujevac, Kragujevac, Serbia; Faculty of Medicine, University of Kragujevac, Kragujevac, Serbia

Assistant professor, Faculty of Medicine, University of Kragujevac,

Pediatric Clinic, Clinical Centre Kragujevac, Kragujevac, Serbia

Nadežda D. Stojanović, Pediatric Clinic, Clinical Centre Kragujevac, Kragujevac, Serbia

Director of Centre of neonatology,Pediatric Clinic, Clinical Centre Kragujevac, Kragujevac, Serbia

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