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Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats
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Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats

Published on: November 20, 2015

Immune Impairment in Preterm Neonates and Its Impact on Morbidity

Ajmal Rafi1, Femitha Pournami1, Vishnu Bhat Ballambattu2

  • 1Department of Neonatology, KIMS Health, Trivandrum, India.

Indian Journal of Pediatrics
|June 24, 2026
PubMed

Insights

Preterm infants

Area of Science:

  • Neonatal immunology
  • Preterm infant health
  • Immune system development

Background:

  • Preterm infants face significant health challenges including sepsis, necrotizing enterocolitis, bronchopulmonary dysplasia, retinopathy of prematurity, and neurodevelopmental impairment.
  • Immune immaturity and dysregulated inflammatory responses are key factors influencing preterm infant vulnerability and disease outcomes.
  • A "host/patient factor" significantly impacts disease presentation, severity, treatment response, and outcomes in preterm neonates.

Purpose of the Study:

  • To review the current literature on immune system alterations in preterm neonates.
  • To discuss the contribution of these immune deviations to common morbidities in preterm infants.
  • To highlight the impact of immune ontogeny, cytokine dysregulation, and oxidative stress on preterm health.

Main Methods:

  • This narrative review synthesizes existing research on preterm infant immunity.
  • It examines alterations in innate, adaptive, and humoral immunity.
  • The review links immune changes to clinical outcomes and discusses data limitations in low- and middle-income settings.

Main Results:

  • Preterm neonates exhibit intrinsic deviations in immune development, affecting innate, adaptive, and humoral responses.
  • These immune alterations are linked to increased risks of sepsis, necrotizing enterocolitis, bronchopulmonary dysplasia, and neurodevelopmental injury.
  • Physiological immune immaturity complicates the interpretation of immune-based screening tools in preterm infants.

Conclusions:

  • Immune immaturity is a critical factor in preterm infant morbidity, influencing susceptibility to major diseases.
  • Further research is needed to understand these immune alterations and their clinical implications, especially in resource-limited settings.
  • Precision medicine approaches may offer future therapeutic strategies for optimizing immune function in preterm infants.

Keywords:
Adaptive and innate immunityCytokinesFlow cytometryOxidative stressPro- inflammatory

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