Salivary cortisol as indicators of pain in preterm infants: a pilot study

Area of Science:

• Neonatal care
• Pain management
• Endocrinology

Background:

• Pain assessment in preterm infants is challenging.
• Salivary cortisol may offer a more specific pain indicator.
• Non-invasive methods are needed for pain evaluation in neonates.

Purpose of the Study:

• To evaluate the feasibility and reliability of salivary cortisol collection and measurement in preterm infants.
• To explore the relationship between salivary cortisol levels and behavioral pain indicators (CRIES) after a heelstick procedure.
• To determine the peak salivary cortisol response time following heelstick in preterm infants.

Main Methods:

• Prospective, descriptive pilot study involving eight healthy preterm infants (30-36 weeks gestational age).
• Serial saliva samples collected without stimulants.
• Cortisol levels measured using enzyme-immune assay.
• Behavioral pain assessed using the CRIES scale.

Main Results:

• The method for saliva collection was feasible.
• Salivary cortisol levels exhibited expected peak and trough patterns.
• Behavioral pain measures (CRIES) did not correlate significantly with peak salivary cortisol levels.

Conclusions:

• Salivary cortisol measurement is a feasible method for assessing pain in preterm infants.
• Further research is needed to understand the relationship between salivary cortisol and behavioral pain indicators.
• Peak response times for salivary cortisol require further investigation in larger cohorts.