Related Experiment Video
Updated: Apr 29, 2026
A Preterm Rat Model for Pain Studies
Published on: February 9, 2024
Neonatal pain and developmental outcomes in children born preterm: a systematic review
Beatriz O Valeri1, Liisa Holsti, Maria B M Linhares
1*Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil †Department of Occupational Science and Occupational Therapy, University of British Columbia and Child and Family Research Institute, Vancouver, BC, Canada.
Insights
Neonatal pain in preterm infants is linked to developmental issues, affecting growth, cognition, and motor skills. More research is needed on long-term impacts of pain exposure in the neonatal intensive care unit.
Area of Science:
- Neonatal care
- Developmental neuroscience
- Pediatric pain research
Background:
- Neonatal intensive care units (NICUs) expose vulnerable infants to numerous painful procedures.
- Cumulative pain exposure may negatively impact neurodevelopmental outcomes.
- Systematic analyses of these effects are limited.
Purpose of the Study:
- To systematically review empirical studies on the association between early neonatal pain experiences in preterm infants and their subsequent developmental outcomes.
- To examine developmental outcomes across different age groups.
Main Methods:
- Comprehensive literature search across PubMed, PsycINFO, Lilacs, and SciELO databases.
- Included keywords: "pain," "preterm," and "development."
- Data extraction based on predefined inclusion and exclusion criteria.
Main Results:
- Thirteen studies analyzed showed associations between neonatal pain and adverse outcomes.
- For extremely preterm infants (≤29 wk), more pain correlated with delayed growth and altered brain development.
- For very preterm infants (≤32 wk), pain reactivity linked to temperament, and neonatal pain experiences impacted cognitive/motor development at 1 year and brain structure at 7 years.
Conclusions:
- Neonatal pain-related stress is associated with early and later developmental alterations in preterm infants.
- Limited longitudinal studies exist on the long-term developmental impact of neonatal pain in this population.
Background:
Neonates cared for in neonatal intensive care units are exposed to many painful and stressful procedures that, cumulatively, could impact later neurodevelopmental outcomes. However, a systematic analysis of these effects is yet to be reported.
Objectives:
The aim of this research was to review empirical studies examining the association between early neonatal pain experiences of preterm infants and the subsequent developmental outcomes of these children across different ages.
Methods:
The literature search was performed using the PubMed, PsycINFO, Lilacs, and SciELO databases and included the following key words: "pain," "preterm," and "development." In addition, a complementary search was performed in online journals that published pain and developmental studies to ensure all of the target studies had been found. The data were extracted according to predefined inclusion and exclusion criteria.
Results:
Thirteen studies were analyzed. In infants born extremely preterm (gestational age ≤29 wk) greater numbers of painful procedures were associated with delayed postnatal growth, with poor early neurodevelopment, high cortical activation, and with altered brain development. In toddlers born very preterm (gestational age ≤32 wk) biobehavioral pain reactivity-recovery scores were associated with negative affectivity temperament. Furthermore, greater numbers of neonatal painful experiences were associated with a poor quality of cognitive and motor development at 1 year of age and changes in cortical rhythmicity and cortical thickness in children at 7 years of age.
Conclusions:
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.
