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DOI: 10.1055/a-2448-0330
Cardiac Troponin-I Level at 24 hours of Age in Stable Newborn Infants Born at ≥35 Weeks of Gestation
Funding None.

Abstract
Objective
Cardiac troponin-I is a known biomarker of myocardial injury in adults and children but its diagnostic utility is unclear in newborns.
This study aimed to establish normative data for troponin-I in stable newborns and assess any variation due to maternal diabetes status, mode of delivery, and Apgar scores.
Study Design
Prospective, observational study of stable newborn ≥35 weeks gestation admitted to a well-baby nursery at a single institution. Infants with respiratory distress, congenital infections, malformations, or syndromes were excluded. Troponin-I values were obtained by a validated point-of-care capillary blood sample at 24 hours of age.
Results
A total of 132 patients were included for analysis. Thirteen infants were born to mothers with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during pregnancy and analyzed as a subgroup, with the remaining 119 infants comprising the base cohort to establish baseline normative troponin-I levels in stable newborn infants. The mean (standard deviation) troponin-I level of infants in the base cohort group was 0.019 ± 0.018 ng/mL and in infants born with maternal SARS-CoV-2 infection during pregnancy troponin-I level was 0.081 ± 0.1 ng/mL (p < 0.001). In infants of the base cohort, there was no significant difference in troponin-I levels between diabetic versus nondiabetic mothers, vaginal birth versus cesarean section, and 5-minute Apgar score of <7 versus ≥7.
Conclusion
Cardiac troponin-I level in healthy term newborns was 0.019 ± 0.018 ng/mL, which conforms to healthy children and adult lab values. There was no statistically significant difference in troponin-I levels in infants of maternal diabetes or normal glucose status, mode of delivery, cesarean versus vaginal, or 5-minute Apgar score of <7 or ≥7. Troponin-I levels in asymptomatic neonates born to mothers with a history of SARS-CoV-2 during pregnancy demonstrated an elevation when compared to the baseline group of infants.
Key Points
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Troponin‐I level, biomarker of myocardial injury, in newborns not requiring delivery‐room.
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Resuscitation is comparable to normal pediatric & adult population independent of mode of delivery or maternal diabetes status.
Authors' Contributions
D.C.R. obtained the consent, collected the data, and wrote the first draft of the manuscript.
C.P. and L.W. ran the point-of-care tests, collected the data, and reviewed the manuscript.
J.C. analyzed the data, reviewed, and revised the manuscript.
J.R. provided the cardiology consultation and follow-up, and reviewed and revised the manuscript.
U.K.M. conceptualized the study, obtained consent, analyzed the results, and revised the manuscript.
Publication History
Received: 08 May 2024
Accepted: 23 October 2024
Article published online:
25 November 2024
© 2024. Thieme. All rights reserved.
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
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