Related Experiment Video
Updated: Mar 27, 2026
A Preterm Rat Model for Pain Studies
Published on: February 9, 2024
Neonatal Invasive Procedures Predict Pain Intensity at School Age in Children Born Very Preterm
Beatriz O Valeri1, Manon Ranger, Cecil M Y Chau
1*Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil †Child & Family Research Institute ‡Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.
Insights
Neonatal pain exposure, including invasive procedures and surgeries, impacts pain perception in very preterm children at school age. Psychosocial factors like parent anxiety also influence later pain ratings.
Area of Science:
- Neonatology
- Developmental Pediatrics
- Pain Research
Background:
- Children born very preterm exhibit altered pain thresholds.
- Limited understanding exists regarding neonatal clinical and psychosocial factors influencing later pain perception in this population.
Purpose of the Study:
- To investigate the association between the number of neonatal invasive procedures and later pain self-ratings in very preterm children.
- To adjust for other clinical and psychosocial factors in this association.
Main Methods:
- Longitudinal follow-up of 56 very preterm children (24-32 weeks gestational age) until 7.5 years.
- Pain assessment using Coloured Analog Scale and Facial Affective Scale during venipuncture.
- Prospective data collection on pain exposure (invasive procedures) and clinical factors; parental questionnaires for psychosocial factors.
Main Results:
- Increased neonatal invasive procedures correlated with higher self-reported pain intensity at age 7.5.
- Higher parent trait-anxiety was associated with increased pain intensity.
- Fewer surgeries and lower child externalizing behaviors were linked to higher pain intensity.
Conclusions:
- Neonatal pain exposure is independently related to altered pain self-ratings in very preterm children at school age.
- Neonatal surgeries and concurrent psychosocial factors also influence pain ratings in this cohort.
Introduction:
Children born very preterm display altered pain thresholds. Little is known about the neonatal clinical and psychosocial factors associated with their later pain perception.
Objective:
We aimed to examine whether the number of neonatal invasive procedures, adjusted for other clinical and psychosocial factors, was associated with self-ratings of pain during a blood collection procedure at school age in children born very preterm.
Materials And Methods:
56 children born very preterm (24 to 32 weeks gestational age), followed longitudinally from birth, and free of major neurodevelopmental impairments underwent a blood collection by venipuncture at age 7.5 years. The children's pain was self-reported using the Coloured Analog Scale and the Facial Affective Scale. Parents completed the Child Behavior Checklist and the State-Trait Anxiety Inventory. Pain exposure (the number of invasive procedures) and clinical factors from birth to term-equivalent age were obtained prospectively. Multiple linear regression was used to predict children's pain self-ratings from neonatal pain exposure after adjusting for neonatal clinical and concurrent psychosocial factors.
Results:
A greater number of neonatal invasive procedures and higher parent trait-anxiety were associated with higher pain intensity ratings during venipuncture at age 7.5 years. Fewer surgeries and lower concurrent child externalizing behaviors were associated with a higher pain intensity.
Conclusions:
In very preterm children, exposure to neonatal pain was related to altered pain self-ratings at school age, independent of other neonatal factors. Neonatal surgeries and concurrent psychosocial factors were also associated with pain ratings.
