TY  - JOUR
A1  - Fortmann, Ingmar
A1  - Dammann, Marie-Theres
A1  - Humberg, Alexander
A1  - Siller, Bastian
A1  - Stichtenoth, Guido
A1  - Engels, Geraldine
A1  - Marißen, Janina
A1  - Faust, Kirstin
A1  - Hanke, Kathrin
A1  - Goedicke-Fritz, Sybelle
A1  - Derouet, Christoph
A1  - Meyer, Sascha
A1  - Stutz, Regine
A1  - Kaiser, Elisabeth
A1  - Herting, Egbert
A1  - Göpel, Wolfgang
A1  - Härtel, Christoph
A1  - Zemlin, Michael
T1  - Five year follow up of extremely low gestational age infants after timely or delayed administration of routine vaccinations
JF  - Vaccines
N2  - 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.
KW  - immunization
KW  - prematurity
KW  - trained immunity
KW  - long-term outcome
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-239592
SN  - 2076-393X
VL  - 9
IS  - 5
ER  - 
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  -