Almost half of all preterm births are caused or triggered by an inflammatory process at the feto-maternal interface resulting in preterm labor or rupture of membranes with or without chorioamnionitis (“first inflammatory hit”). Preterm babies have highly vulnerable body surfaces and immature organ systems. They are postnatally confronted with a drastically altered antigen exposure including hospital-specific microbes, artificial devices, drugs, nutritional antigens, and hypoxia or hyperoxia (“second inflammatory hit”). This is of particular importance to extremely preterm infants born before 28 weeks, as they have not experienced important “third-trimester” adaptation processes to tolerate maternal and self-antigens. Instead of a balanced adaptation to extrauterine life, the delicate co-regulation between immune defense mechanisms and immunosuppression (tolerance) to allow microbiome establishment is therefore often disturbed. Hence, preterm infants are predisposed to sepsis but also to several injurious conditions that can contribute to the onset or perpetuation of sustained inflammation (SI). This is a continuing challenge to clinicians involved in the care of preterm infants, as SI is regarded as a crucial mediator for mortality and the development of morbidities in preterm infants. This review will outline the (i) role of inflammation for short-term consequences of preterm birth and (ii) the effect of SI on organ development and long-term outcome.

在所有早产中，几乎有一半是由胎儿-母亲界面的炎症过程引起或触发的，导致早产或有或没有脉络膜羊膜炎的膜破裂（“初发炎症”）。早产婴儿的身体表面和器官系统非常脆弱。他们出生后面临的抗原暴露急剧变化，包括医院特有的微生物，人工器械，药物，营养抗原以及缺氧或高氧血症（“第二次炎症发作”）。这对于28周之前出生的极早产婴儿特别重要，因为他们没有经历过重要的“孕晚期”适应过程来耐受母体和自身抗原。与其平衡地适应宫外生活，因此，通常会干扰免疫防御机制和免疫抑制（耐受性）之间建立微生物组的微妙的共同调节。因此，早产儿易患败血症，而且易患多种伤害性疾病，这些疾病可导致持续性炎症（SI）的发作或持续。这对从事早产儿护理的临床医生来说是一个持续的挑战，因为SI被认为是早产儿死亡率和发病率的重要介质。这篇综述将概述（i）炎症对于早产的短期后果的作用，以及（ii）SI对器官发育和长期结局的影响。早产儿易患败血症，但也易患多种伤害性疾病，这些疾病可导致持续性炎症（SI）的发作或持续。这对从事早产儿护理的临床医生来说是一个持续的挑战，因为SI被认为是早产儿死亡率和发病率的重要介质。这篇综述将概述（i）炎症对于早产的短期后果的作用，以及（ii）SI对器官发育和长期结局的影响。早产儿易患败血症，但也易患多种伤害性疾病，这些疾病可导致持续性炎症（SI）的发作或持续。这对从事早产儿护理的临床医生来说是一个持续的挑战，因为SI被认为是早产儿死亡率和发病率的重要介质。这篇综述将概述（i）炎症对于早产的短期后果的作用，以及（ii）SI对器官发育和长期结局的影响。