For infants born preterm, neonatal pain-related stress was associated with alterations in both early and in later developmental outcomes. Few longitudinal studies examined the impact of neonatal pain in the long-term development of children born preterm.

Children born very preterm display altered pain thresholds. Little is known about neonatal clinical and psychosocial factors associated with their later pain perception. OBJECTIVE We aimed to examine whether the number of neonatal invasive procedures, adjusted for other clinical and psychosocial factors, was associated with self-ratings of pain during a blood collection procedure in children born very preterm at school age. METHODS 56 children born very preterm (24–32 weeks gestational age) at age 7.5 years, followed longitudinally from birth, and free of major neurodevelopmental impairments, underwent a blood collection by venipuncture. The children’s pain was self-reported using the Coloured Analog Scale and Facial Affective Scale. Parents completed the Child Behavior Checklist and State-Trait Anxiety Inventory. Pain exposure (number of invasive procedures) and clinical factors from birth to term-equivalent age were obtained prospectively. Multiple linear regression was used to predict children’s pain self-ratings from neonatal pain exposure after adjusting for neonatal clinical and concurrent psychosocial factors. RESULTS Greater number of neonatal invasive procedures and higher parent trait-anxiety were associated with higher pain intensity ratings during venipuncture at age 7.5 years. Fewer surgeries and lower concurrent child externalizing behaviors were associated with higher pain intensity. CONCLUSION In very preterm children, exposure to neonatal pain was related to altered pain self-ratings at school age, independent of other neonatal factors. Neonatal surgeries and concurrent psychosocial factors were also associated with pain ratings.

2012Pain in preterm infants: effects of sex, gestational age, and neonatal illness severity Psychol. Neurosci.,v.5,n.1,p.011-019,2012 http://www.producao.usp.br/handle/BDPI/40623 Downloaded from: Biblioteca Digital da Produção Intelectual -BDPI, Universidade de São Paulo Biblioteca Digital da Produção Intelectual -BDPI Sem comunidade ScieloPsychology & Neuroscience, 2012, 5, 1, 11 -19 DOI: 10.3922/j.psns.2012 Pain in preterm infants: effects of sex, gestational age, and neonatal illness severity Most of the studies analyzed more than one of these three variables. The majority of the studies found effects of gestational age (n = 14) and neonatal illness severity (n = 11) on pain responses. Only two studies found an influence of sex on infant pain responses. In conclusion, gestational age and neonatal illness severity influence pain responses in infants born preterm. Further studies should be conducted to examine the influence of sex on pain responses.

Independent of NCR level, sucrose intervention for pain relief during acute painful procedures was effective to reduce pain intensity and increase biobehavioral regulation.