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Subclinical myocardial injury in small-for-gestational-age neonates

Subclinical myocardial injury in small-for-gestational-age neonates
Subclinical myocardial injury in small-for-gestational-age neonates
Objective: Small-for-gestational-age (SGA) infants are at risk for premature death from cardiovascular disease (myocardial infarction and stroke), hypertension, and diabetes in adult life. Severe intrauterine growth restriction is often associated with subclinical cardiovascular abnormalities detectable during fetal echocardiography. The objective of this study was to determine whether SGA newborns have evidence of myocardial injury at birth.
Study design: Cardiac troponin I, a specific marker of myocardial injury widely used for the diagnosis of myocardial infarction in adults, was determined in umbilical cord blood. Umbilical cord venous blood was obtained at the time of birth from 72 SGA newborns (birth weight below the 10th centile for gestational age) and 309 newborns whose birth weights were appropriate for gestational age (AGA). Cardiac troponin I was determined with a commercially available immunoassay (sensitivity 0.2 ng/ml) employed in clinical laboratories (Immulite 2000, Diagnostic Products Corp., Los Angeles, CA).
Results: Cardiac troponin I was not detectable in any of the blood samples from AGA infants. In contrast, 4.2% (3/72) of SGA infants had detectable cardiac troponin I in umbilical cord blood (Fisher's exact test, p = 0.007).
Conclusion: A subgroup of SGA newborns undergoes myocardial injury before birth. This insult may predispose to the development of adult premature cardiovascular disease and death.
small for gestational age, troponin i, myocardial injury
1476-7058
385-390
Chaiworapongsa, T.
6e456b97-2742-466f-9a2d-a096d4ec3500
Espinoza, J.
f3779ca9-13cc-4c5e-bf64-6c1579db10df
Yoshimatsu, J.
61744108-36a9-4543-9543-e10349ec990f
Kalache, K.D.
528a50b8-6bcf-42f6-9fcf-87825ed44304
Edwin, S.
29b4eac5-04a4-4ffa-88b0-11087b655907
Blackwell, S.
f31b9b21-05e0-452b-a469-cd549c88a85e
Yoon, B.H.
e7617432-ecb3-4e11-aaf1-45022ffd49df
Tolosa, J.E.
9210cf72-500e-4744-b6fa-2f3ea46553d3
Silva, M.
49c7a589-7594-4dda-a23a-94e420c59dee
Behnke, E.
bd736773-fb76-49ca-acf2-12905344741f
Gomez, R.
f853dfc0-5282-4c06-aeba-16c1602088ee
Romero, R.
aa0ac4a7-b0d8-412d-9407-ffdaa76bda31
Chaiworapongsa, T.
6e456b97-2742-466f-9a2d-a096d4ec3500
Espinoza, J.
f3779ca9-13cc-4c5e-bf64-6c1579db10df
Yoshimatsu, J.
61744108-36a9-4543-9543-e10349ec990f
Kalache, K.D.
528a50b8-6bcf-42f6-9fcf-87825ed44304
Edwin, S.
29b4eac5-04a4-4ffa-88b0-11087b655907
Blackwell, S.
f31b9b21-05e0-452b-a469-cd549c88a85e
Yoon, B.H.
e7617432-ecb3-4e11-aaf1-45022ffd49df
Tolosa, J.E.
9210cf72-500e-4744-b6fa-2f3ea46553d3
Silva, M.
49c7a589-7594-4dda-a23a-94e420c59dee
Behnke, E.
bd736773-fb76-49ca-acf2-12905344741f
Gomez, R.
f853dfc0-5282-4c06-aeba-16c1602088ee
Romero, R.
aa0ac4a7-b0d8-412d-9407-ffdaa76bda31

Chaiworapongsa, T., Espinoza, J., Yoshimatsu, J., Kalache, K.D., Edwin, S., Blackwell, S., Yoon, B.H., Tolosa, J.E., Silva, M., Behnke, E., Gomez, R. and Romero, R. (2002) Subclinical myocardial injury in small-for-gestational-age neonates. The Journal of Maternal-Fetal & Neonatal Medicine, 11 (6), 385-390.

Record type: Article

Abstract

Objective: Small-for-gestational-age (SGA) infants are at risk for premature death from cardiovascular disease (myocardial infarction and stroke), hypertension, and diabetes in adult life. Severe intrauterine growth restriction is often associated with subclinical cardiovascular abnormalities detectable during fetal echocardiography. The objective of this study was to determine whether SGA newborns have evidence of myocardial injury at birth.
Study design: Cardiac troponin I, a specific marker of myocardial injury widely used for the diagnosis of myocardial infarction in adults, was determined in umbilical cord blood. Umbilical cord venous blood was obtained at the time of birth from 72 SGA newborns (birth weight below the 10th centile for gestational age) and 309 newborns whose birth weights were appropriate for gestational age (AGA). Cardiac troponin I was determined with a commercially available immunoassay (sensitivity 0.2 ng/ml) employed in clinical laboratories (Immulite 2000, Diagnostic Products Corp., Los Angeles, CA).
Results: Cardiac troponin I was not detectable in any of the blood samples from AGA infants. In contrast, 4.2% (3/72) of SGA infants had detectable cardiac troponin I in umbilical cord blood (Fisher's exact test, p = 0.007).
Conclusion: A subgroup of SGA newborns undergoes myocardial injury before birth. This insult may predispose to the development of adult premature cardiovascular disease and death.

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More information

Published date: 2002
Keywords: small for gestational age, troponin i, myocardial injury

Identifiers

Local EPrints ID: 25355
URI: http://eprints.soton.ac.uk/id/eprint/25355
ISSN: 1476-7058
PURE UUID: 0a1efd85-26b4-4f60-867c-bf314839f38c

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Date deposited: 12 Apr 2006
Last modified: 15 Jul 2019 19:16

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Contributors

Author: T. Chaiworapongsa
Author: J. Espinoza
Author: J. Yoshimatsu
Author: K.D. Kalache
Author: S. Edwin
Author: S. Blackwell
Author: B.H. Yoon
Author: J.E. Tolosa
Author: M. Silva
Author: E. Behnke
Author: R. Gomez
Author: R. Romero

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