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Unlocking the first year: Immunologic, hematologic, and lung health challenges in premature infants

Sui-Ling Liao1, Li-Chen Chen2, Ming-Han Tsai1

  • 1Department of Pediatrics, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan; Chang Gung University, College of Medicine, Taoyuan, Taiwan.

Pediatrics and Neonatology
|November 4, 2025
PubMed

Insights

Preterm infants show comparable anemia rates to full-term infants by one year. However, unique immune and lung function profiles persist, particularly in those born before 34 weeks gestation, necessitating continued monitoring.

Area of Science:

  • Neonatal Health
  • Pediatric Immunology
  • Pulmonary Medicine

Background:

  • Limited data exists on immune, hematologic, and lung function development in preterm infants post-neonatal period.
  • This study investigates the maturation of these systems in preterm infants by one year of age compared to full-term infants.

Purpose of the Study:

  • To assess if immune, hematologic, and lung function in preterm infants reach levels comparable to full-term infants by one year corrected age.
  • To identify potential long-term differences in these systems.

Main Methods:

  • Compared Toll-like receptor (TLR)-induced cytokine responses, iron deficiency anemia prevalence, and infant lung function (ILFT) in preterm and full-term infants at 1 year.
  • Analyzed cytokine responses (IL-6, IL-10) to TLR7/8 and phytohemagglutinin stimulation.
  • Measured ILFT parameters, including tidal volume.

Main Results:

  • Iron deficiency anemia prevalence was similar between preterm (22.7%) and full-term (18.4%) infants at 1 year.
  • Preterm infants showed reduced IL-6 and IL-10 responses to TLR stimulation compared to full-term infants.
  • No significant overall ILFT differences were found, but infants born before 34 weeks gestation had lower tidal volumes.

Conclusions:

  • Anemia prevalence is comparable between preterm and full-term infants by one year.
  • Preterm infants, especially those born extremely preterm (<34 weeks), may exhibit distinct immunologic and pulmonary function profiles extending beyond infancy.
  • Ongoing monitoring is recommended for preterm infants to manage their unique health needs.
Abstract

Keywords:
AnemiaInnate immunityLungPremature infantsToll-like receptors

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