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  -