Cord blood cardiac troponin I, fetal Doppler velocimetry, and acid base status at birth

Abstract Objective To analyze the association between umbilical cord cardiac troponin I (cTnI), obstetric Doppler, and birth acidemia. Method: This prospective observational study was conducted on 58 singleton pregnancies at 3 Brazilian hospitals. Umbilical and middle cerebral artery Doppler velocimetry were performed 24 h prior to birth. At delivery, cord blood was collected for pH, blood gas analysis, and cTnI measurement. Results: Cardiac troponin I ≥ 0.20 ng/mL was detected in 5 neonates (8.6%). Centralization was recorded in 12 fetuses; 4 of these (33.3%) had detectable cTnI compared with 1/46 (2.2%) fetuses with normal Doppler ( P  = 0.005). Acidemia was present in 60% of the neonates with detectable cTnI, compared with 15% of the neonates with undetectable cTnI ( P  = 0.042). Conclusion: Centralization and birth acidemia are associated with detectable cTnI in cord blood supporting the possibility of myocardial ischemia in these fetuses.