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Updated: Mar 2, 2026
A Preterm Rat Model for Pain Studies
Published on: February 9, 2024
Pain threshold, tolerance and intensity in adolescents born very preterm or with low birth weight
Christ-Jan J L M van Ganzewinkel1, Jasper V Been2, Inge Verbeek3
1Department of Pediatrics, Division of Neonatology, Máxima Medical Centre, De Run 4600, 5504 MB Veldhoven, The Netherlands.
Insights
Neonatal pain can have long-term effects. Maladaptive pain coping and necrotizing enterocolitis (NEC) in preterm adolescents are linked to altered pain responses, including lower pain thresholds and tolerance.
Area of Science:
- Neonatal care
- Adolescent health
- Pain research
Background:
- Limited data exists on the long-term consequences of neonatal pain.
- Understanding these effects is crucial for improving long-term health outcomes in preterm infants.
Purpose of the Study:
- To investigate the association between perinatal factors, later pain experiences, and pain coping strategies with pain perception in adolescents born preterm.
- To identify potential risk factors for altered pain responses in this vulnerable population.
Main Methods:
- An observational, longitudinal study (Project on Preterm and SGA-infants, POPS-19) analyzed data from 412 adolescents (born <32 weeks gestation or <1500g).
- Pain threshold, tolerance, and intensity were assessed using a cold pressor test.
- Pain coping strategies were evaluated using a pain coping questionnaire (PCQ).
Main Results:
- Female gender and necrotizing enterocolitis (NEC) were linked to lower pain tolerance and threshold.
- Emotion-focused avoidance pain coping was significantly associated with lower pain threshold and tolerance.
- NEC was also significantly associated with a lower pain threshold and tolerance in multivariate analyses.
Conclusions:
- Maladaptive pain coping strategies in adolescence are associated with reduced pain threshold and tolerance, and increased pain intensity.
- Necrotizing enterocolitis (NEC) is a significant perinatal factor associated with altered pain responses in adolescents born preterm.
Background:
Data on long-term consequences of neonatal pain is limited.
Aim:
To assess whether perinatal factors, later pain experience and pain coping strategies are associated with altered pain threshold, pain tolerance and pain intensity in adolescents born preterm.
Study Design:
Observational, longitudinal study (Project on Preterm and SGA-infants, POPS-19).
Subjects:
We analyzed data of 412 adolescents at the age of 19years, who were born at a gestational age<32weeks or with a birth weight<1500g.
Outcome Measures:
Participants performed a standardized cold pressor test to assess pain threshold, tolerance and intensity. Furthermore, they completed a pain coping questionnaire (PCQ).
Results:
In univariate analysis, female gender and necrotizing enterocolitis (NEC) were associated with lower pain tolerance, indicated by reaching the ceiling time of 180s in ice water (females 19% vs males 29%, NEC 7% vs no NEC 25%). Female gender was associated with higher pain intensity (mean difference 0.58; 95%CI 0.21; 0.95) and lower pain threshold (log rank test p 0.007). In a multivariate Cox regression analyses, emotion focused avoidance pain coping style was significantly associated with lower pain threshold (hazard ratio HR 1.38; 95%CI 1.02; 1.87) and pain tolerance (HR 1.72; 95%CI 1.21; 2.42). NEC was significantly associated with lower pain threshold (HR 1.47; 95%CI 1.01; 2.14) and pain tolerance (HR 1.63; 95%CI 1.09; 2.41).
Conclusion:
In adolescence, maladaptive pain coping strategy was associated with lower pain threshold, pain tolerance and higher pain intensity. NEC was associated with altered pain response in adolescents born preterm.
