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Five Year Follow Up of Extremely Low Gestational Age Infants after Timely or Delayed Administration of Routine

Ingmar Fortmann1,2, Marie-Theres Dammann1, Alexander Humberg1

  • 1Department of Pediatrics, University of Lübeck, 23538 Lübeck, Germany.

Vaccines
|June 2, 2021
PubMed

Insights

Nearly 10% of extremely low gestational age neonates (ELGANs) experience delayed vaccinations, particularly those with health complications. Timely immunization in ELGANs is linked to reduced bronchitis risk by age five.

Area of Science:

  • Neonatalogy
  • Immunology
  • Pediatric Public Health

Background:

  • Extremely low gestational age neonates (ELGANs) are a vulnerable population requiring specialized care.
  • Immunization is crucial for protecting infants from vaccine-preventable diseases.
  • Timely vaccination schedules are essential for optimal immune development and protection.

Purpose of the Study:

  • To determine the rate of untimely immunization in ELGANs within the German Neonatal Network (GNN).
  • To identify risk factors associated with delayed vaccination in this cohort.
  • To investigate the long-term health consequences of vaccination delays in ELGANs up to five years of age.

Main Methods:

  • An observational study was conducted using data from the GNN between January 2010 and December 2019.
  • Immunization status for hexavalent and pneumococcal vaccines was assessed in 8401 preterm infants (<29 weeks gestation).
  • Statistical analyses, including univariate and regression models, were employed to identify risk factors and outcomes.

Main Results:

  • 9.8% (n=824) of ELGANs did not receive timely initial immunization.
  • Risk factors for delay included small for gestational age (SGA) status, impaired growth, and complicated clinical courses (e.g., necrotizing enterocolitis).
  • At five years, timely immunized children had a significantly lower risk of bronchitis (27.3% vs. 37.7%).

Conclusions:

  • A significant proportion of ELGANs experience delayed vaccinations, especially those with higher vulnerability.
  • These infants may particularly benefit from timely vaccination due to its immune-promoting effects.
  • Delayed immunization in ELGANs is associated with increased risk of respiratory issues like bronchitis by age five.

Keywords:
immunizationlong-term outcomeprematuritytrained immunity

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