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Published on: February 9, 2024
Methodological Issues in the Study of the Development of Pain Responsivity in Preterm Neonates: A Systematic Review
1Department of Human Studies, University of Ferrara, via Paradiso, 12, 44100 Ferrara, Italy.
Insights
Understanding pain in preterm neonates is crucial. This study reveals that gestational age, postmenstrual age, and chronological age uniquely influence neonatal pain responses, highlighting the need for methodological consistency in research.
Area of Science:
- Neonatal development
- Pain research
- Clinical neonatology
Background:
- Neonatal pain response development is critical for research and clinical care.
- Preterm neonates undergo frequent painful procedures.
- Systematic review needed on age-related pain responsivity in premature infants.
Purpose of the Study:
- To systematize knowledge on pain response development in premature neonates.
- To focus on key methodological issues concerning age variables.
- To analyze the impact of gestational age, postmenstrual age, and chronological age on pain responsivity.
Main Methods:
- Systematic literature search on Medline and Scopus.
- Identification of 42 studies examining age variables and pain responsivity.
- Categorization of studies based on age terminologies, methodologies, and outcome variables (facial, non-facial behavioral, physiological).
Main Results:
- Distinct multidimensional developmental patterns in pain responsivity were observed for each age-sampling strategy.
- Gestational age (GA), postmenstrual age (PMA), and chronological age (CH) each appear to influence pain responsivity.
- The impact of these age variables may differ across various age windows.
Conclusions:
- Each age variable (GA, PMA, CH) significantly affects neonatal pain responsivity, albeit potentially in distinct ways.
- Further research requires targeted and integrated approaches.
- Methodological consistency is essential for advancing understanding of pain development in preterm neonates.
Abstract:
The study of the development of neonatal pain responses is of key importance, both for research and for clinical reasons, with particular regard to the population of preterm neonates, given the amount of painful procedures they are exposed to on a daily basis. The aim of this work was to systematize our knowledge about the development of pain responses in prematurely born neonates by focusing on some key methodological issues. Studies on the impact of age variables, namely gestational age (GA), postmenstrual age (PMA) and chronological age (CH), on pain responsivity in premature neonates were identified using Medline and Scopus. Studies (N = 42) were categorized based on terminological and methodological approaches towards age variables, and according to output variables considered (facial, nonfacial behavioral, physiological). Distinct multidimensional developmental patterns were found for each age-sampling strategy. Overall, each of the three age variables seems to affect pain responsivity, possibly differently across age windows. Targeted as well as integrated approaches, together with a renewed attention for methodological consistency, are needed to further our knowledge on this topic.
