Hypothalamic-pituitary-adrenal axis function and the cellular immune response in former preterm children.
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.
Buske-Kirschbaum
A
A
Department of Biopsychology, Technical University of Dresden, D-01062 Dresden, Germany. buske@biopsych.tu-dresden.de
Krieger
S
S
Wilkes
C
C
Rauh
W
W
Weiss
S
S
Hellhammer
D H
DH
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
D006854:Hydrocortisone