TREC and KREC in very preterm infants: reference values and effects of maternal and neonatal factors

Abstract

Objective

T-cell receptor excision circles (TREC) and kappa-deleting recombination excision circles (KREC) assays have been used for severe combined immunodeficiencies newborn screening (NBS). We assessed TREC and KREC NBS values in preterm infants and investigated if perinatal characteristics affect their values.

Methods

We performed a retrospective study collecting data from TREC and KREC NBS database and from mothers’ and infants’ medical charts.

Results

TREC and KREC values were lower in preterm infants born at 23–31 or 32–36 weeks of gestation than in term infants. Gestational age <28 weeks of gestation, leukopenia, and hypertensive disorders of pregnancy lowered TREC. Hypertensive disorders of pregnancy lowered KREC and intrapartum fever >38 °C increased it. Low TREC and KREC values were not associated to the risk of developing early-onset sepsis and late-onset sepsis.

Conclusion

TREC and KREC levels are lower in preterm than term infants, but this did not increase the risk of neonatal sepsis.

Keywords:

• Immunodeficiency
• KREC
• preterm infant
• sepsis
• TREC

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethics

The study protocol was approved by the Pediatrics Tuscany Ethics Committee.