title: Hypothalamic-pituitary-adrenal axis function and the cellular immune response in former preterm children.
abstract: BACKGROUND
  Animal data suggest that adverse early experiences may affect endocrine and immune functioning in later life.
  
  
  OBJECTIVE
  Our objective was to assess the impact of preterm delivery on hypothalamus-pituitary-adrenal axis functioning, heart rate responses, and immune function.
  
  
  METHODS
  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.
  
  
  METHODS
  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)].
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  The data suggest that preterm delivery may be associated with altered endocrine and immune functions well into late childhood.
authors.affiliation: Department of Biopsychology, Technical University of Dresden, D-01062 Dresden, Germany. buske@biopsych.tu-dresden.de
authors.forename: A
authors.initials: A
authors.lastname: Buske-Kirschbaum
authors.forename: S
authors.initials: S
authors.lastname: Krieger
authors.forename: C
authors.initials: C
authors.lastname: Wilkes
authors.forename: W
authors.initials: W
authors.lastname: Rauh
authors.forename: S
authors.initials: S
authors.lastname: Weiss
authors.forename: D H
authors.initials: DH
authors.lastname: Hellhammer
mesh_terms: D000293:Adolescent; D001143:Arousal / Q000502:physiology; D016022:Case-Control Studies; D002648:Child; D002940:Circadian Rhythm; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis; D006968:Hypersensitivity, Delayed / Q000276:immunology; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology*; D007111:Immunity, Cellular / Q000502:physiology*; D008297:Male; D010913:Pituitary-Adrenal System / Q000502:physiology*; D011247:Pregnancy; D047928:Premature Birth / Q000503:physiopathology*; D011581:Psychological Tests; D013315:Stress, Psychological / Q000503:physiopathology
chemical_list: D006854:Hydrocortisone