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Updated: Jun 10, 2026
Electrophysiological Measurements and Analysis of Nociception in Human Infants
Published on: December 20, 2011
Determinants of premature infant pain responses to heel sticks
Lina Kurdahi Badr1, Bahia Abdallah, Mirvat Hawari
1Azusa Pacific University Azusa, CA, USA.
Insights
Premature infants
Area of Science:
- Neonatal care
- Pediatric neurology
- Pain management
Background:
- Neonatal intensive care involves painful procedures.
- Infant pain exposure may impact neurodevelopment and behavior.
- Accurate pain assessment in preterm infants is crucial.
Purpose of the Study:
- To compare pain responses in preterm infants during a heel stick.
- To investigate factors influencing pain scores, including medication use.
- To analyze the relationship between gestational age and pain.
Main Methods:
- Descriptive, cross-sectional study of 72 preterm infants.
- Pain assessed using the Preterm Infant Pain Profile (PIPP) scale.
- Multiple linear regression analyzed predictors of pain scores.
Main Results:
- Lower gestational age infants had higher pain scores.
- Gestational age, needle type, illness severity, and behavioral state predicted pain.
- Opioid and sedative use did not correlate with pain scores.
- Predictors accounted for 44% of pain score variance.
Conclusions:
- Sick preterm infants may not show obvious pain signs.
- Precise pain assessment and management are vital for vulnerable infants.
- Early life stress can affect long-term development.
Abstract:
The exposure of premature infants to stressors, such as pain intended to ensure their survival, may instead alter their brain development and contribute to several learning and behavioral difficulties observed in later childhood. The objective of this descriptive, cross-sectional study was to compare the pain responses of 72 preterm infants to a heel stick procedure taking into consideration a variety of factors, including the use of opioids and sedatives. The pain scores assessed on the Preterm Infant Pain Profile (PIPP) scale were highest for the lowest gestational age (GA) group. Multiple linear regression analysis with the four predictor variables noted to be correlated with the PIPP scores (GA, type of needle, severity of illness, and behavioral state) indicated a significant overall relationship (F [5/66] = 5.62, p < 0.01) and accounted for 44% of the variance. All but severity of illness did not add significantly to the variance. Gender, postnatal age, amount, opioids, and sedatives used were not correlated to the PIPP scores. It was concluded that sick premature infants and those who have been exposed to a variety of painful procedures may not manifest behavioral or physiological signs of pain, but may be the most to benefit from precise pain assessment and prudent management.
