Т-РЕЦЕПТОРНЫЕ И КАППА-ДЕЛЕЦИОННЫЕ РЕКОМБИНАЦИОННЫЕ ЭКСЦИЗИОННЫЕ КОЛЬЦА КАК ИНСТРУМЕНТ ОЦЕНКИ ФУНКЦИИ Т- И В-КЛЕТОЧНОГО ЗВЕНА ИММУНИТЕТА У НОВОРОЖДЕННЫХ С ЭКСТРЕМАЛЬНО НИЗКОЙ МАССОЙ ТЕЛА ПРИ РОЖДЕНИИ: ФАКТОРЫ РИСКА

Abstract

Early detection of newborns with congenital immune errors has become possible as yet thanks to the recent nationwide introduction of expanded neonatal screening into routine practice. The stake of false-positive results is higher in premature infants than in other age groups. This therefore requires further and more thorough investigation of both TREC and KREC dynamics in preterm infants. The purpose of this research was to identify significant factors affecting the levels of TREC and KREC in infants born with extremely low birth weight and to evaluate the dynamics of these parameters depending on the gestational age. Materials and methods used: the study that involved 43 (51,2% (22) girls/48,8% (21) boys) extremely low birth weight newborns with gestational age of 26 [25; 27] weeks who were born at the Perinatal Center with the Voronezh Oblast Regional Clinical Hospital No. 1 (Voronezh, Russia) in 2022-2024 had been carried out. The dynamics of TREC and KREC indicators from the gestational age was evaluated. The influence of significant prenatal and postnatal factors on TREC and KREC indicators was considered. The material for the study was dried blood spots drawn on Guthrie cards and taken as part of neonatal screening. Results: it was revealed that TREC levels increased, KREC values remained relatively stable with increasing gestation period. A decrease in TREC levels is observed in newborns who were born to mothers whose pregnancy was complicated by fetoplacental insufficiency (p=0,012) as well as in those who had required the extended cardiotonic support aiming to stabilize the main hemodynamic parameters (p=0.042). A decrease in KREC levels was observed in newborns from mothers with a history of two and more frozen pregnancies (p<0,001). Conclusion: statistically significant prenatal and postnatal factors affecting TREC and KREC levels in children born with extremely low birth weight have been revealed. The dynamics of TREC/KREC indices depending on the gestational age was noted.