2023
DOI: 10.1002/pne2.12112
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Cortisol levels are related to neonatal pain exposure in children born very preterm at age 18 months in two independent cohorts

Mia A. McLean,
Lisa Nakajima,
Cecil M. Y. Chau
et al.

Abstract: Exposure to pain‐related stress from frequent invasive procedures in the neonatal intensive care unit (NICU) has been associated with altered physiological stress regulation, neurodevelopment, and behavior in children born very preterm (≤32 weeks gestation). Previously, in a cohort born 2003–2006 (Cohort 1), we found that, at 18 months corrected age (CA), children born extremely low gestational age (ELGA; 24–28 weeks) and very low gestational age (VLGA; 29–32 weeks), had higher pre‐test cortisol levels and a d… Show more

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Cited by 5 publications
(3 citation statements)
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“…Unfortunately, clinical studies did not include possible gender differences in their analysis. Altogether, our results and previous clinical and preclinical studies suggest an age-and sex-dependent effect of repetitive neonatal procedural pain on the HPA axis (Brummelte et al, 2015;Chen et al, 2016;Grunau et al, 2004;Lowe et al, 2023;McLean et al, 2023;Mooney-Leber & Brummelte, 2020;Olszewska et al, 2022). Given that many studies did not include longitudinal and gendered effects, conclusions must be taken with precaution and additional longitudinal research including gender-related aspects is required.…”
Section: Discussionsupporting
confidence: 46%
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“…Unfortunately, clinical studies did not include possible gender differences in their analysis. Altogether, our results and previous clinical and preclinical studies suggest an age-and sex-dependent effect of repetitive neonatal procedural pain on the HPA axis (Brummelte et al, 2015;Chen et al, 2016;Grunau et al, 2004;Lowe et al, 2023;McLean et al, 2023;Mooney-Leber & Brummelte, 2020;Olszewska et al, 2022). Given that many studies did not include longitudinal and gendered effects, conclusions must be taken with precaution and additional longitudinal research including gender-related aspects is required.…”
Section: Discussionsupporting
confidence: 46%
“…Furthermore, the HPA axis response depends on negative feedback from glucocorticoids on the glucocorticoid receptors (GR) and the mineralocorticoid receptors (MR), an adaptive response under the influence of sex hormones and epigenetically sensitive to early-life events (De Kloet et al, 1998;Goel et al, 2011;Keller-Wood & Dallman, 1984;Nicolaides et al, 2015). Early-life adversities, including repetitive neonatal procedural pain, promote continued increase of glucocorticoids levels in rodents and human alike (Grunau et al, 2004;McLean et al, 2023;Mooney-Leber et al, 2018;Olszewska et al, 2022;Victoria, Karom, et al, 2013). Rodent females may be more sensitive to the heightened glucocorticoids levels as suggested by their higher ACTH response at P8 following ether inhalation (Hary & Dupouy Isabelle Grégoire, 1986).…”
Section: Discussionmentioning
confidence: 99%
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