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Pain-associated stressor exposure and neuroendocrine values for premature infants in neonatal intensive care

Annie J Rohan1

  • 1School of Nursing, Stony Brook University, Health Sciences Center-Level 2, Office 247, Stony Brook, NY, 11794. annie.rohan@stonybrook.edu.

Developmental Psychobiology
|August 21, 2015
PubMed

Insights

Neonatal intensive care unit (NICU) stress impacts premature infants. Cumulative pain exposure, not birth factors, significantly correlated with 17-hydroxyprogesterone (17-OHP) levels at 37 weeks postmenstrual age.

Area of Science:

  • Neonatalogy
  • Endocrinology
  • Developmental Pediatrics

Background:

  • Neonatal intensive care unit (NICU) environments present significant stressors for premature infants.
  • Recurrent stress may negatively impact adaptive capacity and long-term developmental outcomes.
  • Understanding the physiological stress response in preterm infants is crucial for optimizing care.

Purpose of the Study:

  • To examine the relationship between resting adrenocorticoid levels and cumulative pain-associated stressor exposure in preterm infants.
  • To investigate if early life stress predicts later physiological stress markers.
  • To identify key factors influencing stress hormone levels in this vulnerable population.

Main Methods:

  • Descriptive, cross-sectional study design with a life course perspective.
  • Inclusion of 59 infants born before 35 weeks gestation, cared for in the NICU.
  • Measurement of resting adrenocorticoid values (cortisol and 17-OHP) at 37 postmenstrual weeks, correlated with various stressor exposures.

Main Results:

  • No significant correlations were found between cortisol levels and study variables (e.g., gestational age, birthweight, ventilation hours).
  • A significant negative correlation was identified between the number of skin-breaking procedures and 17-hydroxyprogesterone (17-OHP) values (r = -0.232, p = 0.039).
  • Pain-associated stressor exposure emerged as a more significant factor for 17-OHP variance than birthweight, gestational age, or chronological age.

Conclusions:

  • Cumulative pain exposure in the NICU may be a more critical determinant of 17-OHP levels at 37 weeks postmenstrual age than traditional measures like birthweight or gestational age.
  • The findings suggest that minimizing painful procedures is essential for modulating the endocrine stress response in preterm infants.
  • Further research is warranted to explore the long-term neurodevelopmental implications of early life stress and 17-OHP levels.

Keywords:
17-hydroxyprogesteroneallostasisallostatic loadcortisolneonatal intensive careneonateneurodevelopmentpainpain-associated stressorpremature infantprocedural painstress

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