Neonatal pain, thalamic development and sensory processing behaviour in children born very preterm

Area of Science:

• Neuroscience
• Developmental Pediatrics
• Neonatology

Background:

• Altered sensory processing is common in very preterm infants (gestational age ≤32 weeks).
• Immature nervous system development, particularly thalamocortical connections, may be vulnerable to sensory overload.
• This vulnerability may contribute to the observed sensory processing difficulties.

Purpose of the Study:

• To investigate if neonatal procedural pain and thalamic development predict sensory processing in preschool-aged children born very preterm.
• To explore the relationship between early life experiences and later neurodevelopmental outcomes.

Main Methods:

• A prospective longitudinal cohort study included 140 very preterm infants (median GA 28 weeks).
• Infants underwent MRI scans early in life and at term-equivalent age.
• Sensory processing was assessed at 4.5 years using parent-reported Short Sensory Profile, with statistical models adjusting for covariates.

Main Results:

• Among extremely preterm neonates (24-28 weeks GA), more invasive procedures correlated with poorer sensory processing (p=0.03).
• Greater thalamic growth from birth to term-equivalent age was associated with fewer sensory problems overall (p<0.001).
• Extremely preterm infants with high procedural exposure and slower thalamic growth showed the most significant sensory processing issues (p=0.01).

Conclusions:

• Early pain exposure and associated thalamic alterations are key factors for sensory problems in extremely preterm children.
• Neonatal pain management and monitoring thalamic development may be crucial for improving long-term outcomes.
• These findings highlight critical early-life factors influencing neurodevelopmental trajectories in vulnerable preterm populations.