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J Clin Endocrinol Metab. 2007 Sep;92(9):3429-35. Epub 2007 Jun 12.

Hypothalamic-pituitary-adrenal axis function and the cellular immune response in former preterm children.

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  • 1Department of Biopsychology, Technical University of Dresden, D-01062 Dresden, Germany.



Animal data suggest that adverse early experiences may affect endocrine and immune functioning in later life.


Our objective was to assess the impact of preterm delivery on hypothalamus-pituitary-adrenal axis functioning, heart rate responses, and immune function.


Former preterm children [aged 8-14 yr (n = 18)], sex and age-matched full-term born control children (n = 18), data on birth weight, gestational age, birth weight for gestational age (in sd units), actual body weight, height, and body mass index were assessed.


Subjects were exposed to a standardized laboratory stressor ("Trier Social Stress Test for Children"). Cortisol in saliva was determined in 10-min intervals before and after the stress test; heart rates were obtained continuously during the stress test. Additional assessment of saliva cortisol was performed: 1) on 3 consecutive days after awakening and at +10, +20, and +30 min (morning cortisol); and 2) at 0800, 1400, 1600, and 1900 h (short diurnal profile). Measurement of the delayed type hypersensitivity reaction to seven recall antigens [Multitest cellular mediated immunity (Multitest-Immignost, Biosyn, Fellbach, Germany)].


Exposure to the Trier Social Stress Test for Children yielded significantly increased cortisol levels [F (8, 232) = 19.86; P < 0.001] and heart rates [F (38, 988) = 10.46; P < 0.001], however, no difference between former preterms and full-terms could be observed. No between-group differences were found in the short diurnal cortisol profile. Former preterms showed significantly higher cortisol levels after awakening [F (3, 102) = 3.14; P < 0.05]. In addition, a significantly suppressed delayed type hypersensitivity response [reduced number of positive antigens (t = -2.64, P < 0.05); induration (t = -2.4, P < 0.05)] was found in former preterms.


The data suggest that preterm delivery may be associated with altered endocrine and immune functions well into late childhood.

[PubMed - indexed for MEDLINE]
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