INTRODUCTION High-sensitivity cardiac troponin T (hs-cTnT) is not used routinely as a diagnostic biomarker in newborns. The high precision of hs-cTnT assays increases the ability to determine small differences in cTnT over time and to detect troponin T elevation; thus, we believe that hs-cTnT assays might improve clinical care. We explored the plausible association between hs-cTnT levels (ng/L) in healthy newborns and prolonged second stage of labor, neonatal, and maternal factors. METHODS A prospective study was performed among healthy newborns in the Obstetrics and Gynecology Department at Hillel Yaffe Medical Center in Israel in January-June 2021. The sociodemographic characteristics of the participants, maternal age, gravidity, parity, Pitocin use, epidural analgesia, and neonatal anemia were obtained from the electronic medical records. Gestational age was determined by ultrasound biometric measurements. We classified second-stage labor as normal or prolonged using the WHO guidelines. Samples from umbilical cord blood were drawn using syringes rinsed with anticoagulant by a specialist in pediatrics. The remaining blood was used to determine hs-cTnT levels (ng/L), which was defined as a continuous quantitative variable with the median value and the 25th-75th percentiles. RESULTS Overall, 184 cord blood samples were performed from healthy newborns (60.6% males) with a median hs-cTnT of 39.03 (25th-75th percentiles = 30.53-54.09) ng/L. A multivariable linear regression model showed no significant association between neonatal anemia and hs-cTnT levels (ng/L) (p = 0.8). Gestational age (B coefficient -4.24, p < 0.001) and gravidity (B coefficient -2.41, p = 0.03) were negatively associated with hs-cTnT levels (ng/L), while Pitocin use (B coefficient 6.91, p = 0.04) and prolonged second stage of labor (B coefficient 18.07, p = 0.02) were positively associated with hs-cTnT levels (ng/L). CONCLUSIONS High hs-cTnT levels (ng/L) were documented in the cord blood of healthy newborns. Hs-cTnT levels were positively correlated with a prolonged second stage of labor and Pitocin use and negatively correlated with longer gestational age and higher gravidity. Hs-cTnT may signify labor-related fetal distress. A larger surveillance study is mandatory to establish this correlation and assess for possible prognostic significance of elevated hs-cTnT in this context.

中文翻译：

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健康新生儿高敏心肌肌钙蛋白 T 与第二产程延长、新生儿和母亲因素之间的关联：一项前瞻性研究。

简介 高敏心肌肌钙蛋白 T (hs-cTnT) 并不常规用作新生儿的诊断生物标志物。hs-cTnT 检测的高精度提高了确定 cTnT 随时间变化的微小差异以及检测肌钙蛋白 T 升高的能力；因此，我们相信 hs-cTnT 检测可能会改善临床护理。我们探讨了健康新生儿的 hs-cTnT 水平 (ng/L) 与第二产程延长、新生儿和母亲因素之间的合理关联。方法 2021 年 1 月至 6 月，对以色列 Hillel Yaffe 医疗中心妇产科的健康新生儿进行了一项前瞻性研究。参与者的社会人口学特征、产妇年龄、妊娠情况、产次、催产素使用、硬膜外镇痛和新生儿情况贫血症是从电子病历中获得的。胎龄是通过超声生物测量确定的。我们根据世界卫生组织的指南将第二产程分为正常产程和延长产程。儿科专家使用用抗凝剂冲洗的注射器抽取脐带血样本。剩余的血液用于测定 hs-cTnT 水平 (ng/L)，其定义为具有中值和第 25-75 个百分位数的连续定量变量。结果 总体而言，从健康新生儿（60.6% 为男性）采集了 184 份脐带血样本，hs-cTnT 中位数为 39.03（第 25-75 个百分位数 = 30.53-54.09）ng/L。多变量线性回归模型显示新生儿贫血与 hs-cTnT 水平 (ng/L) 之间没有显着相关性 (p = 0.8)。胎龄（B 系数 -4.24，p < 0.001）和妊娠（B 系数 -2.41，p = 0.03）与 hs-cTnT 水平（ng/L）呈负相关，而催产素的使用（B 系数 6.91，p = 0.04）第二产程延长（B 系数 18.07，p = 0.02）与 hs-cTnT 水平 (ng/L) 呈正相关。结论 健康新生儿的脐带血中记录到高 hs-cTnT 水平 (ng/L)。Hs-cTnT 水平与第二产程延长和催产素使用呈正相关，与较长胎龄和较高妊娠呈负相关。Hs-cTnT 可能表示与分娩相关的胎儿窘迫。必须进行更大规模的监测研究来建立这种相关性并评估 hs-cTnT 升高在这种情况下可能的预后意义。