Changes in high-sensitivity troponin I dynamics pre and post parturition are phenotype specific

Area of Science:

• Cardiovascular Medicine
• Obstetrics
• Biomarkers

Background:

• Hypertensive disorders of pregnancy, including preeclampsia and gestational hypertension, significantly contribute to maternal morbidity and future cardiovascular disease.
• The interpretation of cardiac troponin dynamics in the peripartum period for these conditions remains understudied.

Purpose of the Study:

• To evaluate peripartum high-sensitivity troponin I (hs-cTnI) dynamics.
• To compare hs-cTnI patterns across pregnancies with preeclampsia, gestational hypertension, and normotensive controls.

Main Methods:

• A retrospective cohort study analyzed serum or plasma samples collected within ±48 hours of delivery.
• Mixed-effects linear regression models were used to assess log10-transformed hs-cTnI concentrations and temporal slopes.
• Analyses adjusted for demographic and obstetric covariates.

Main Results:

• Among 609 participants, hs-cTnI levels increased significantly after delivery across all groups.
• Preeclampsia exhibited the greatest post-delivery rise in hs-cTnI, followed by hypertension and normotensive controls.
• Multivariable analyses confirmed higher hs-cTnI levels and steeper peripartum slopes in preeclampsia compared to normotensive controls.

Conclusions:

• Delivery serves as a physiological cardiovascular stress test, with peripartum hs-cTnI trajectories varying by hypertensive status.
• Preeclampsia is associated with significantly greater myocardial stress compared to normotensive pregnancies.
• Marked hs-cTnI increases during delivery are uncommon in normal pregnancies and warrant further diagnostic evaluation.