Abstract
<title>Abstract</title> <p> <bold>Background</bold> : Birth asphyxia accounts for more than a million neonatal deaths worldwide. Cardiovascular dysfunction following hypoxic myocardial injury has been reported in up to a third of these asphyxiated neonates and is known to contribute to the high mortality rate associated with birth asphyxia. This study aimed to compare cardiac troponin I levels and electrocardiographic (ECG) changes in asphyxiated and non-asphyxiated neonates and determine the prognostic value of both in asphyxiated neonates at the University of Uyo Teaching Hospital (UUTH). <bold>Method</bold> : The study was conducted at the Newborn Unit of the UUTH over seven months from March 2023 to September 2023. Fifty term neonates (25 with birth asphyxia and 25 healthy controls) aged twelve hours or less, were enrolled after informed parental consent. A structured study proforma was completed for each participant before physical examination, electrocardiography, and cardiac troponin I assay. Neonates who had moderate or severe birth asphyxia using the combined criteria of APGAR score at 5th minute and Sarnat and Sarnat staging were recruited as the asphyxiated group while age and sex-matched healthy neonates were recruited as the non-asphyxiated group. <bold>Result</bold> : The median (Interquartile Range) cardiac troponin I value in asphyxiated neonates was 0.29 ng/mL (0.21-0.47), which was significantly higher than the median (Interquartile Range) of 0.023 ng/mL (0.018-0.030) obtained in the non-asphyxiated neonates <italic>(p</italic> <0.001) and also higher than the 0.1 ng/mL considered as upper limit for normal levels. Also, cardiac troponin I level greater than 0.5 ng/mL was associated with an increased likelihood of mortality from asphyxia ( <italic>p</italic> = 0.010). All asphyxiated neonates had abnormal ECG patterns and 56% had ST-segment abnormalities classified as grade III according to Jedeikin’s criteria compared to the non-asphyxiated neonates where only 3(12%) had abnormal ECG findings, most of which were T wave abnormalities. <bold>Conclusion</bold> : Elevated cardiac troponin I concentrations and abnormal ECG findings were significantly more common among neonates with birth asphyxia in this study when compared to non-asphyxiated neonates. Also, cardiac troponin I was demonstrated to be a better predictor of mortality than electrocardiographic abnormalities in asphyxiated neonates </p>