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This version published online on June 12, 2007
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2006-2223
A more recent version of this article appeared on September 1, 2007
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Submitted on October 12, 2006
Accepted on June 4, 2007

Hypothalamic-Pituitary-Adrenal Axis Function and the Cellular Immune Reponse in Former Preterm Children

A. Buske-Kirschbaum*, S. Krieger, C. Wilkes, W. Rauh, S. Weiss, and D. H. Hellhammer

Dept. of Psychology, Technical University of Dresden, 01026 Dresden, Germany; Dept. of Psychobiology, University of Trier, 54290 Trier, Germany; Dept. of Pediatrics, Mutterhaus der Borromäerinnen, 54290 Trier, Germany

* To whom correspondence should be addressed. E-mail: buske{at}biopsych.tu-dresden.de.

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

Objective: To assess the impact of preterm delivery on HPA axis functioning, heart rate responses and immune function.

Participants: Former preterm children, aged 8-14 years (n=16); sex and age matched full-term born control children (n=16); data on birth weight, gestational age, birth weight for gestational age (in SD units), acutal body weight, height and body mass index were assessed.

Design and outcome measures: Subjects were exposed to a standardized laboratory stressor (TSST-C). Cortisol in saliva was determined in ten minutes intervals before and after the stress test; heart rates were obtained continuously during the stress test. Additional assessment of saliva cortisol (a) on three consecutive days after awakening, and +10, +20, and +30 minutes (morning cortisol) and (b) on 8:00 AM, 2:00 PM, 4:00 PM and 8:00 PM (short diurnal profile). Measurement of the DTH reaction to seven recall antigens (Multitest®CMI).

Results: Exposure to the TSST-C yielded in significantly increased cortisol levels (F(8,232)=19.86; p<.001) and heart rates (F(38,988)=10.46; p<.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 CORT levels after awakening (F(3,102)=3.14; p<.05). Additionally, a significantly suppressed DTH response (reduced number of positive antigens (t=-2.64, p<.05); induration (t=-2.4; p<.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.
Key words: preterms • hypothalamus-pituitary adrenal (HPA) axis • cortisol • delayed-type hypersensitivity reaction • stress




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