neonatal arrhythmias, risk factors, troponin I, сopeptin


Background. Neonatal arrhythmias, for the most part, have a good prognosis for recovery. However, they can also have an adverse course and lead to the development of life-threatening conditions. Therefore, it is important to search for earlier markers of myocardial lesion, diagnostic criteria and predictors of arrhythmias. Purpose. Improvement of diagnosis and prediction of the risk of cardiac arrhythmias and conduction in newborns in the early neonatal period by identifying factors that play a role in the prediction of neonatal arrhythmias. Subjects & Methods. The study involved 76 newborns. Group 1 included 57 infants with arrhythmias according to Holter monitoring, Group 2 included 19 infants without arrhythmias. The study implied a comparison of history data, laboratory and instrumental findings, levels of troponin I and copeptin. To predict the development of neonatal arrhythmias, logistic regression analysis was performed. The quality of the model was tested using the Percent Concordant (PC). Quality Score was evaluated by R2 Nigelkerke. Model adequacy was estimated using the Hosmer-Lemeshow test. Results. The study showed that the factors that can influence the development of arrhythmias in the early neonatal period are the level of umbilical cord blood, the levels of troponin I, copeptin, GGT, assessment of Apgar scale in the 1st and 5th minutes, asphyxia at birth, indices of wave R amplitude in V3 and V5 of chest leads, ST segment deviation from the isoline according to standard surface ECG, QTc levels and mean daily maximum, minimum heart rate according to Holter monitoring. Conclusions. Predictors of neonatal arrhythmias development are indicators of laboratory-instrumental parameters of cardiovascular system status, troponin I level above 0.29 ng/ml and copeptin level above 0.1 ng/ml.


Ban, J.-E. (2017). Neonatal arrhythmias: diagnosis, treatment, and clinical outcome. Korean. J. Pediatr, 60(11), 344-352. doi: 10.3345/kjp.2017.60.11.344

Silva, A., Soares, P., Flor-de-Lima, F., Moura, C., Areias, J. C., Guimarães, H. (2016). Neonatal arrhythmias – morbidity and mortality at discharge. Journal of Pediatric and Neonatal Individualized Medicine, 5(2). doi: 10.7363/050212

Shikuku, D. N., Benson, M., Ayebare, E. (2018). Practice and outcomes of neonatal resuscitation for newborns with birth asphyxia at Kakamega County General Hospital, Kenya: a direct observation study. BMC Pediatr, 18, 167. doi:10.1186/s12887-018-1127С6

Morales, P., Bustamante, D., Espina-Marchant, P., Neira-Pena, T., Gutierrez-Hernandez, M. A., Allende-Castro, C, Rojas-Mancilla, E. (2011). Pathophysiology of perinatal asphyxia: can we predict and improve individual outcomes? EPMA J, 2(2), 211-30.

Jaeggi, E., Оhman, A. (2016). Fetal and Neonatal Arrhythmias. Clin. Perinatol, 43, 99-112. Retrieved from

Costa, S., Zecca, E., De Rosa, G., De Luca, D., Barbato, G., Pardeo, M., Romagnoli, C. (2007). Is serum troponin T a useful marker of myocardial damage in newborn infants with perinatal asphyxia? Acta Paediatr, 96(2), 181-4.

Suzuki, K., Komukai, K., Nakata, K., Kang, R., Oi, Y., Muto, E. (2018). The Usefulness and Limitations of Point-of-care Cardiac Troponin Measurement in the Emergency Department. Intern Med, 57(12), 1673-80.

Cabral, M., Leite-Moreira, A., Monterroso, J., Ramalho, C., Guimarães, H. (2016). Myocardial Injury Biomarkers in Newborns with Congenital Heart Disease. Pediatr. Neonatol, 57 (6), 488-495. doi: 10.1016/j.pedneo.2015.11.004.

Cai, F., Li, M. X., Pineda-Sanabria, S. E., Gelozia, S., Lindert, S., West, F., Sykes, B. D., Hwang, P. M. (2016). Structures reveal details of small molecule binding to cardiac troponin. Journal of Molecular and Cellular Cardiology, 101, 134-144.

Bolignano, D., Cabassi, A., Fiaccadori, E., Ghigo, E., Pasquali, R., Peracino, A., Peri, A., Plebani, M., Santoro, A., Settanni, F., Zoccali, C. (2014). Copeptin (CTproAVP), a new tool for understanding the role of vasopressin in pathophysiology. Clinical Chemistry and Laboratory Medicine, 52(10), 1447-56.

Baumert, M., Surmiak, P., Wiecek, A., Walencka, Z. (2017). Serum NGAL and copeptin levels as predictors of acute kidney injury in asphyxiated neonates. Clinical and Experimental Nephrology, 21, 658–664.

Rey, C., García-Cendón, C., Martínez-Camblor, P., López-Herce, J., Concha-Torre, A., Medina, A., Vivanco-Allende, A., Mayordomo-Colunga, J. (2016). High levels of atrial natriuretic peptide and copeptin and mortality risk. Anales de Pediatría, 85(6), 284-290.

Kelen, D., Andorka, C., Szabо, M., Alafuzoff, A., Kaila, K., Summanen, M. (2017). Serum copeptin and neuron specific enolase are markers of neonatal distress and long-term neurodevelopmental outcome. PLoS One, 12(9), e0184593.

Summanen, M., Seikku, L., Rahkonen, P., Stefanovic, V., Teramo, K., Andersson, S., Kaila, K., Rahkonen, L. (2017). Comparison of Umbilical Serum Copeptin Relative to Erythropoietin and S100B as Asphyxia Biomarkers at Birth. Neonatology, 112(1), 60-66.

Krakauer, M. G., Gowen, C. W. (2020-2019). Birth Asphyxia. Jr StatPearls. Retrieved from

Drago, F., Battipaglia, I., Mambro, D. (2018). Neonatal and Pediatric Arrhythmias: Clinical and Electrocardiographic Aspects. Card Electrophysiol Clin, 10(2), 397-412. doi: 10.1016/j.ccep.2018.02.008

Hodovanets, Yu. D., Peryzhniak, A. I. (2016). Pathogenetic aspects of cardiovascular disorders in newborn infants with hypoxic defeats. Neonatology, surgery and perinatal medicine, 1(19), 21-26.

Artyomova, N. S., Korobka, O.V., Pokhylko, V. I., Tsvirenko, S. M., Kovalova O. M. (2017). Integrated model for the prediction of organic dysfunctions development in newborns with asphyxia and applied points of its implementation. Neonatology, surgery and perinatal medicine, 4(26), 24-30.

Method for differential diagnosis of cardiac arrhythmias and conduction in early neonatal period in premature infants with intraventricular hemorrhage. Retrieved from

Method for differential diagnosis of cardiac arrhythmias and conduction in term neonates with asphyxia. Retrieved from

A method for predicting the outcome of posthypoxic disorders of the cardiovascular system in newborns. Retrieved from

Method for predicting risk of development of severe post-hypoxic myocardial damage in newborns with different period of gestation in the neonatal period. Retrieved from

Copyright for articles published in the journal is regulated by the License Agreement for the use of a scientific article in the journal, which is concluded between the author of the article (Licensor) and Kharkov National Medical University (Licensee, publisher of the journal "Inter Collegas"). The licensor grants to the Licensee a non-exclusive non-exclusive license for the use of the article (a license that does not exclude the use of the article by the Licensor and the issuance of licenses to others for use of this article) on the terms and for the period specified in the contract. The licensor (the author of the article) grants the Licensee the right to reproduce the article (publication in the journal "Inter Collegas", publication, duplication, duplication or other reproduction of the article without limiting the circulation of copies, each copy of the article must contain the name of the Licensor; Of general information, including the publication of the article in full or in part on the Internet on the journal page, the right to use the metadata of the article (titles, full names of authors, annotations, bibliography eskih materials) through the dissemination and communication to the public, processing and systematization, as well as inclusion in various databases and in-formational system).

The licensor grants the licensee the right to transfer, store and process his personal data (full name, scientific degree, academic title, place of work and position, contact information of the authors) with the purpose of including them in the database in accordance with the Law of Ukraine No. 2297 - VI "on protection of personal data" from 01.06.2010.

Personal data and metadata of the article are provided for their storage and processing in various databases and information systems, including them in analytical and statistical reporting, creating sound relationships between the objects of works of science, literature and art with personal data, etc. on unlimited territory. The licensee has the right to transfer the specified data for processing and storage to third parties provided that such a fact is notified with the provision of information about the third party (name and address) to the Licensor.