@article{FortmannDammannHumbergetal.2021,
  author    = {Fortmann, Ingmar and Dammann, Marie-Theres and Humberg, Alexander and Siller, Bastian and Stichtenoth, Guido and Engels, Geraldine and Marißen, Janina and Faust, Kirstin and Hanke, Kathrin and Goedicke-Fritz, Sybelle and Derouet, Christoph and Meyer, Sascha and Stutz, Regine and Kaiser, Elisabeth and Herting, Egbert and G{\"o}pel, Wolfgang and H{\"a}rtel, Christoph and Zemlin, Michael},
  title     = {Five year follow up of extremely low gestational age infants after timely or delayed administration of routine vaccinations},
  series = {Vaccines},
  volume    = {9},
  journal   = {Vaccines},
  number    = {5},
  issn      = {2076-393X},
  doi       = {10.3390/vaccines9050493},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-239592},
  year      = {2021},
  abstract  = {This study is aimed at detecting the rate of untimely immunization in a large cohort of extremely low gestational age neonates (ELGANs) of the German Neonatal Network (GNN) and at addressing risk factors for delayed vaccination and associated long-term consequences. We performed an observational study of the GNN between 1st January 2010 and 31st December 2019. The immunization status for the hexavalent and pneumococcal immunization was evaluated in n = 8401 preterm infants <29 weeks of gestation. Univariate analysis and logistic/linear regression models were used to identify risk factors for vaccination delay and outcomes at a 5-year follow-up. In our cohort n = 824 (9.8\%) ELGANs did not receive a timely first immunization with the hexavalent and pneumococcal vaccine. Risk factors for delayed vaccination were SGA status (18.1\% vs. 13.5\%; OR 1.3; 95\% CI: 1.1-1.7), impaired growth and surrogates for complicated clinical courses (i.e., need for inotropes, necrotizing enterocolitis). At 5 years of age, timely immunized children had a lower risk of bronchitis (episodes within last year: 27.3\% vs. 37.7\%; OR 0.60, 95\% CI: 0.42-0.86) but spirometry measures were unaffected. In conclusion, a significant proportion of ELGANs are untimely immunized, specifically those with increased vulnerability, even though they might particularly benefit from the immune-promoting effects of a timely vaccination.},
  language  = {en}
}
@article{HumbergFortmannSilleretal.2020,
  author    = {Humberg, Alexander and Fortmann, Ingmar and Siller, Bastian and Kopp, Matthias Volkmar and Herting, Egbert and G{\"o}pel, Wolfgang and H{\"a}rtel, Christoph},
  title     = {Preterm birth and sustained inflammation: consequences for the neonate},
  series = {Seminars in Immunopathology},
  volume    = {42},
  journal   = {Seminars in Immunopathology},
  organization    = {German Neonatal Network, German Center for Lung Research and Priming Immunity at the beginning of life (PRIMAL) Consortium},
  issn      = {1863-2297},
  doi       = {10.1007/s00281-020-00803-2},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-235019},
  pages     = {451-468},
  year      = {2020},
  abstract  = {Almost half of all preterm births are caused or triggered by an inflammatory process at the feto-maternal interface resulting in preterm labor or rupture of membranes with or without chorioamnionitis ("first inflammatory hit"). Preterm babies have highly vulnerable body surfaces and immature organ systems. They are postnatally confronted with a drastically altered antigen exposure including hospital-specific microbes, artificial devices, drugs, nutritional antigens, and hypoxia or hyperoxia ("second inflammatory hit"). This is of particular importance to extremely preterm infants born before 28 weeks, as they have not experienced important "third-trimester" adaptation processes to tolerate maternal and self-antigens. Instead of a balanced adaptation to extrauterine life, the delicate co-regulation between immune defense mechanisms and immunosuppression (tolerance) to allow microbiome establishment is therefore often disturbed. Hence, preterm infants are predisposed to sepsis but also to several injurious conditions that can contribute to the onset or perpetuation of sustained inflammation (SI). This is a continuing challenge to clinicians involved in the care of preterm infants, as SI is regarded as a crucial mediator for mortality and the development of morbidities in preterm infants. This review will outline the (i) role of inflammation for short-term consequences of preterm birth and (ii) the effect of SI on organ development and long-term outcome.},
  language  = {en}
}