Prematurity alters skin conductance and behavioural scoring after acute stress in term‐equivalent age infants

Abstract

Aim The primary objective was to assess the effect of prematurity at term‐equivalent age on skin conductance and behavioural responses to acute stress. The secondary objective was to explore the reliability of skin conductance in detecting neonatal discomfort in preterm and full‐term populations. Methods Very preterm infants at term‐equivalent age and healthy full‐term neonates, 34 infants in each group, underwent the hip dysplasia screening test. The acute pain in newborn infants (APN) scale was scored before and 15, 45 and 90 seconds after stimulus. Skin conductance was measured in the 30‐second time‐lap before and after stimulus. Results The APN score was lower in preterm infants after intervention (term: 5.4 ± 2.8 vs. preterm: 3.9 ± 2.2; p = 0.03). Peaks‐per‐second, a skin conductance parameter, exhibited lower basal values in preterm infants than in term infants, with similar rise induced by stressful challenge. Peaks‐per‐second values were correlated to the 15‐second APN score in both groups (term: r = 0.55, p < 0.001; preterm: r = 0.43, p = 0.01). Conclusion Preterm birth changed skin conductance signal and behavioural response to stress at term‐equivalent age. The skin conductance device may be an objective tool for a continuous monitoring of acute neonatal stress.

The validity of skin conductance for assessing acute pain in mechanically ventilated infants: A cross‐sectional observational study

“…To our best knowledge, 34 previous studies focusing on the use of SC in infants have been published, including 28 studies synthesized in the recent scoping review and six studies published after the scoping review (Hu et al, 2019;Maillard et al, 2019;Meesters et al, 2019;Oji-Mmuo et al, 2019;Passariello et al, 2019;Pettersson et al, 2019;Roue et al, 2018). This present study is the first to evaluate different sources of validity evidence of SC for pain assessment in the same population of infants during the same time period.…”

The skin conductance-based non-invasive pain assessment instrument for infants

“…The following procedures were performed before applying electrodes to infants in previous studies: providing a comfortable / neutral thermal environment 5,15 , keeping clean 5,15 , giving feeds 5, 15 1 hour prior 16 , restricting stimulation 5,17 for at least 1 hour 15 , minimal handling, giving a pacifier, and giving 25% oral glucose 15 , or sucrose 18 , then placed on the open-bed 19 , wearing nappies and a top 5 , opening the cover of both legs, one hand and part of the abdomen, and cleaned the skin area by rubbing alcohol 20 or normal physiological saline 21 for 30 seconds 20 . After the electrodes have been applied, then the area where the electrodes are placed is wrapped 22,23 and the cable secured with a band around the ankle area 24 .…”

“…Studies show increasing use of SC to measure infant pain in the past several years 4 . Many recent studies find SC to be an objective 5 , simple, non-invasive, rapid and accurate tool to detect autonomic reflex function in the neonate 6 . This review of infant pain measurement and SCbased pain measurement is derived from database ________________________________________…”

Acute pain measured with the modified Bernese Pain Scale for Neonates is influenced by individual contextual factors

“…PNA because of the multiple stressful and painful procedures they experience during their NICU stay (Maillard, Garnier, Saliba, & Favrais, 2019).…”