Troponin I, creatine-phosphokinase and creatine-phosphokinase-MB in newborns with suspected neonatal asphyxia

The cardiac troponin I (cTnI), creatine phospokinase (CPK), and creatine kinase- myocardial band (CK-MB) are cardiac biomarkers used in newborns with asphyxia.

To analyze the relationship between cTnI, CPK and CPK-MB levels with clinical and biochemical diagnostic criteria for neonatal asphyxia.

Analytical cross-sectional study in neonates with at least one diagnostic criterion of asphyxia. Relationship among cTnI and CPK-MB levels at birth, serum levels of CPK and CPK-MB determined 24 hours after delivery, with metabolic acidosis, Apgar test at 5 minutes with scores of 0-3, neurological alterations and/or multiple organ failure were analyzed.

Thirty-four neonates, 73.5% born by cesarean section, 71% term neonates with a mean weight of 3,096 ± 453g, 2,275 ± 509g for preterm, and a mean of 7.77 ± 1.481 and 7.03 ± 1.705 5-minute Apgar score, respectively. 17.6% of the neonates reported a pH value < 7.20, 58% a base deficit of 12 mmol/L, 5.8% obtained a 5-minute Apgar score < 3, and 38.23% had neurological alterations and/or multiple organ dysfunction syndrome. All patients reported cTnI within the normal reference range. CPK and CPK-MB values, 24 hours after delivery, were elevated in 29% of the cases with one or two diagnostic criteria for neonatal asphyxia. The percentage of CPK-MB was associated with gestational age.

cTnI values were normal in suspected cases of neonatal asphyxia, whereas CPK and CPK MB can elevate in these population, principally in preterm newborns. Biochemical markers were not associated with any clinical parameter.