TY  - JOUR
A1  - Humberg, Alexander
A1  - Fortmann, Ingmar
A1  - Siller, Bastian
A1  - Kopp, Matthias Volkmar
A1  - Herting, Egbert
A1  - Göpel, Wolfgang
A1  - Härtel, Christoph
T1  - Preterm birth and sustained inflammation: consequences for the neonate
JF  - Seminars in Immunopathology
N2  - 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.
KW  - preterm infants
KW  - sustained inflammation
KW  - sepsis
KW  - microbiome
KW  - neurocognitive outcome
KW  - chronic pulmonary insufficiency of prematurity
Y1  - 2020
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-235019
SN  - 1863-2297
VL  - 42
ER  - 
TY  - JOUR
A1  - Härtel, Christoph
A1  - Spiegler, Juliane
A1  - Fortmann, Ingmar
A1  - Astiz, Mariana
A1  - Oster, Henrik
A1  - Siller, Bastian
A1  - Viemann, Dorothee
A1  - Keil, Thomas
A1  - Banaschewski, Tobias
A1  - Romanos, Marcel
A1  - Herting, Egbert
A1  - Göpel, Wolfgang
T1  - Breastfeeding for 3 months or longer but not probiotics is associated with reduced risk for inattention/hyperactivity and conduct problems in very-low-birth-weight children at early primary school age
JF  - Nutrients
N2  - (1) Background: We aimed to evaluate the effect of proposed “microbiome-stabilising interventions”, i.e., breastfeeding for ≥3 months and prophylactic use of Lactobacillus acidophilus/ Bifidobacterium infantis probiotics on neurocognitive and behavioral outcomes of very-low-birthweight (VLBW) children aged 5–6 years. (2) Methods: We performed a 5-year-follow-up assessment including a strength and difficulties questionnaire (SDQ) and an intelligence quotient (IQ) assessment using the Wechsler Preschool and Primary Scale of Intelligence (WPPSI)-III test in preterm children previously enrolled in the German Neonatal Network (GNN). The analysis was restricted to children exposed to antenatal corticosteroids and postnatal antibiotics. (3) Results: 2467 primary school-aged children fulfilled the inclusion criteria. In multivariable linear regression models breastfeeding ≥3 months was associated with lower conduct disorders (B (95% confidence intervals (CI)): −0.25 (−0.47 to −0.03)) and inattention/hyperactivity (−0.46 (−0.81 to −0.10)) as measured by SDQ. Probiotic treatment during the neonatal period had no effect on SDQ scores or intelligence. (4) Conclusions: Prolonged breastfeeding of highly vulnerable infants may promote their mental health later in childhood, particularly by reducing risk for inattention/hyperactivity and conduct disorders. Future studies need to disentangle the underlying mechanisms during a critical time frame of development.
KW  - breastfeeding
KW  - probiotic prophylaxis
KW  - preterm children
KW  - strength and difficulties
KW  - inattention/hyperactivity
KW  - intelligence
Y1  - 2020
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-216319
SN  - 2072-6643
VL  - 12
IS  - 11
ER  -