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Published on: November 20, 2015
Pain and neurodevelopmental outcomes of infants born very preterm
Vito Giordano1, Philipp Deindl2, Elisabeth Gal1
1Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria.
Insights
Pain experienced by preterm infants in the neonatal intensive care unit impacts neurodevelopmental outcomes. Effective pain management is crucial for improving long-term development in these vulnerable infants.
Area of Science:
- Neonatology
- Developmental Pediatrics
- Pain Medicine
Background:
- Preterm infants experience significant pain in the neonatal intensive care unit (NICU).
- Pain exposure in early life can have lasting effects on neurodevelopment.
- Understanding the relationship between neonatal pain and neurodevelopmental outcomes is critical for optimizing care.
Purpose of the Study:
- To investigate the impact of neonatal pain levels on neurodevelopmental outcomes in preterm infants.
- To assess the association between pain experienced during NICU stay and later developmental assessments.
Main Methods:
- Retrospective analysis of 196 preterm infants (23-32 weeks gestational age) from 2011-2015.
- Pain assessed using the Neonatal Pain, Agitation, and Sedation Scale.
- Neurodevelopment evaluated at 1 year corrected age using the Bayley Scales of Infant Development.
Main Results:
- Infants exposed to pain showed significantly poorer mental and motor development compared to those with no pain.
- These differences remained significant after controlling for other medical conditions.
- A total of 196 infants were analyzed, with 105 in the 'no pain' group and 91 in the 'pain' group.
Conclusions:
- Neonatal pain exposure is linked to altered neurodevelopmental outcomes in very preterm infants at 12 months corrected age.
- Adequate pain management in the NICU is essential to mitigate risks of adverse neurodevelopmental outcomes.
- This study underscores the importance of pain assessment and management in preterm neonates.
Aim:
To investigate the impact of the level of pain experienced by infants born preterm on neurodevelopmental outcomes during their stay in a neonatal intensive care unit.
Method:
In this retrospective data analysis we included all surviving infants born preterm with a gestational age between 23 and 32 weeks from 2011 to 2015, who were assessed using the Neonatal Pain, Agitation, and Sedation Scale and examined at 1 year of age using the Bayley Scales of Infant Development. We excluded all infants who had suffered severe neurological morbidities and undergone surgical interventions.
Results:
A total of 196 infants born preterm were included in the analyses: 105 in the 'no pain group' and 91 in the 'pain group'. Significant differences between the groups were detected for both mental and motor development (p = 0.003, 95% confidence interval [CI] 2.23-10.92; p = 0.025, 95% CI 0.64-9.78). The results remained significant after controlling for other important medical conditions (p = 0.001, 95% CI -19.65 to -5.40; p = 0.010, 95% CI -16.18 to -2.29).
Interpretation:
Neonatal pain exposure was associated with altered neurodevelopmental outcomes of infants born very preterm at a corrected age of 12 months. This observation highlights the importance of adequate pain management to reduce the risk of poor neurodevelopmental outcomes in these vulnerable patients.
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