Background: Community acquired pneumonia (CAP) is a high incidence disease resulting in about 260,000 hospital admissions per year in Germany, more than myocardial infarction or stroke. Worldwide, CAP is the most frequent infectious disease with high lethality ranging from 1.2 % in those 20–29 years old to over 10 % in patients older than 70 years, even in industrial nations. CAP poses numerous medical challenges, which the PROGRESS (Pneumonia Research Network on Genetic Resistance and Susceptibility for the Evolution of Severe Sepsis) network aims to tackle: Operationalization of disease severity throughout the course of disease, outcome prediction for hospitalized patients and prediction of transitions from uncomplicated CAP to severe CAP, and finally, to CAP with sepsis and organ failure as a life-threatening condition. It is a major aim of PROGRESS to understand and predict patient heterogeneity regarding outcome in the hospital and to develop novel treatment concepts. Methods: PROGRESS was designed as a clinical, observational, multi-center study of patients with CAP requiring hospitalization. More than 1600 patients selected for low burden of co-morbidities have been enrolled, aiming at a total of 3000. Course of disease, along with therapy, was closely monitored by daily assessments and long-term follow-up. Daily blood samples allow in depth molecular-genetic characterization of patients. We established a well-organized workflow for sample logistics and a comprehensive data management system to collect and manage data from more than 50 study centers in Germany and Austria. Samples are stored in a central biobank and clinical data are stored in a central data base which also integrates all data from molecular assessments. Discussion: With the PROGRESS study, we established a comprehensive data base of high quality clinical and molecular data allowing investigation of pressing research questions regarding CAP. In-depth molecular characterization will contribute to the discovery of disease mechanisms and establishment of diagnostic and predictive biomarkers. A strength of PROGRESS is the focus on younger patients with low burden of co-morbidities, allowing a more direct look at host biology with less confounding. As a resulting limitation, insights from PROGRESS will require validation in representative patient cohorts to assess clinical utility. Trial registration: The PROGRESS study was retrospectively registered on May 24th, 2016 with ClinicalTrials.gov: NCT02782013

Background: Community acquired pneumonia (CAP) is a high incidence disease resulting in about 260,000 hospital admissions per year in Germany, more than myocardial infarction or stroke. Worldwide, CAP is the most frequent infectious disease with high lethality ranging from 1.2 % in those 20–29 years old to over 10 % in patients older than 70 years, even in industrial nations. CAP poses numerous medical challenges, which the PROGRESS (Pneumonia Research Network on Genetic Resistance and Susceptibility for the Evolution of Severe Sepsis) network aims to tackle: Operationalization of disease severity throughout the course of disease, outcome prediction for hospitalized patients and prediction of transitions from uncomplicated CAP to severe CAP, and finally, to CAP with sepsis and organ failure as a life-threatening condition. It is a major aim of PROGRESS to understand and predict patient heterogeneity regarding outcome in the hospital and to develop novel treatment concepts. Methods: PROGRESS was designed as a clinical, observational, multi-center study of patients with CAP requiring hospitalization. More than 1600 patients selected for low burden of co-morbidities have been enrolled, aiming at a total of 3000. Course of disease, along with therapy, was closely monitored by daily assessments and long-term follow-up. Daily blood samples allow in depth molecular-genetic characterization of patients. We established a well-organized workflow for sample logistics and a comprehensive data management system to collect and manage data from more than 50 study centers in Germany and Austria. Samples are stored in a central biobank and clinical data are stored in a central data base which also integrates all data from molecular assessments. Discussion: With the PROGRESS study, we established a comprehensive data base of high quality clinical and molecular data allowing investigation of pressing research questions regarding CAP. In-depth molecular characterization will contribute to the discovery of disease mechanisms and establishment of diagnostic and predictive biomarkers. A strength of PROGRESS is the focus on younger patients with low burden of co-morbidities, allowing a more direct look at host biology with less confounding. As a resulting limitation, insights from PROGRESS will require validation in representative patient cohorts to assess clinical utility. Trial registration: The PROGRESS study was retrospectively registered on May 24th, 2016 with ClinicalTrials.gov: NCT02782013

Theoretischer Hintergrund: Aktuelle Studien zeigen spezifische Zusammenhänge von peripartalen psychischen Störungen und kindlichen Entwicklungsauffälligkeiten. Fragestellung: Haben Kinder von Müttern mit einer peripartalen Angst- oder depressiven Störung ein erhöhtes Risiko für (visuo–)‌motorische, sprachliche und kognitive Entwicklungsauffälligkeiten? Methode: In der prospektiven MARI-Studie (N = 306) wurden peripartale psychische Störungen mit dem CIDI-V in jedem Schwangerschaftstrimester sowie 2, 4 und 16 Monate nach der Geburt erhoben. Die kindliche Entwicklung wurde mit dem Neuropsychologischen Entwicklungs-Screening im Alter von 4 (N = 263) und 16 Monaten (N = 241) erfasst. Ergebnisse: Maternale depressive Störungen vor der Schwangerschaft waren negativ mit der visuellen Entwicklung (4 Monate; OR = 3.3) und der Haltungs- und Bewegungssteuerung (16 Monate; OR = 4.4) des Kindes assoziiert. Diskussion: Entwicklungsauffälligkeiten könnten u. a. durch ein verändertes Interaktionsverhalten (z. B. weniger Blickkontakt/Ermutigung) betroffener Mütter begründet sein. / Theoretical background: Anxiety and depressive disorders are among the most prevalent perinatal disorders, and specific associations with child development have to be distinguished to derive early targeted interventions. Objective: Are children of mothers with peripartum anxiety or depressive disorder at increased risk for (visuo–)‌motor, language, and cognitive developmental abnormalities? Method: In this prospective-longitudinal MARI study, N = 306 women were examined three time during pregnancy and at 2, 4, and 16 months after delivery using the Composite International Diagnostic Interview for Women (CIDI-V) to assess their anxiety and depressive disorders. Child development was assessed at 4 (N = 263) and 16 months postpartum (N = 241) using a standardized development test (Neuropsychologisches Entwicklungs-Screening, NES). Results: Maternal depressive disorders prior to pregnancy were associated with infant visual development at 4 months (OR = 3.3) and motor development at 16 months (OR = 4.4) postpartum. The results remained stable after adjustment for preterm delivery and perceived maternal social support. Discussion and conclusion: Developmental adversities in infants of mothers with prior depressive disorders might be explained by altered mother-child interaction (e. g., less eye contact, less engagement). Early identification of expectant mothers with a history of depressive disorders is crucial for early targeted intervention. Further studies are needed to examine the mechanisms of transmission to derive innovative approaches for prevention.