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A Preterm Rat Model for Pain Studies
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A Preterm Rat Model for Pain Studies

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Early-life painful and stressful exposures and neurodevelopment in preterm infants

Tingting Zhao1, Aolan Li2, Ming-Hui Chen3

  • 1School of Nursing, Columbia University, New York, NY, United States.

Frontiers in Pediatrics
|May 29, 2026
PubMed

Insights

Early pain and stress impact preterm infant neurodevelopment, with Black and male infants experiencing more pain. Mother's own milk (MOM) intake may offer protection, highlighting its role in neonatal care.

Area of Science:

  • Neonatal care
  • Neurodevelopmental outcomes
  • Pediatric research

Background:

  • Early-life painful and stressful exposures are linked to neurodevelopmental outcomes in preterm infants.
  • Existing research on race, sex, and mother's own milk (MOM) intake in these associations is inconsistent.

Purpose of the Study:

  • To investigate the association between early-life painful exposures and neurodevelopmental outcomes in preterm infants.
  • To examine the moderating roles of race, sex, and mother's own milk (MOM) intake in these associations.

Main Methods:

  • A cohort of 196 preterm infants (28-32 weeks gestation) was followed to 2 years corrected age (CA).
  • Painful exposures were quantified using composite pain scores (Neonatal Infant Stressor Scale).
  • Neurodevelopment was assessed using NICU Network Neurobehavioral Scale, Bayley-III, and BITSEA; data analyzed with linear mixed-effects and regression models.

Main Results:

  • Higher early painful exposures correlated with poorer self-regulation, attention, and increased stress/lethargy at 36-38 weeks postmenstrual age (PMA).
  • Among Black infants, higher pain scores predicted lower language and motor scores at 1 and 2 years CA, and lower cognitive scores at 1 year CA.
  • Male infants with higher pain scores showed lower motor scores at 1 year CA compared to females; greater MOM intake was linked to lower pain scores but did not moderate the pain-neurodevelopment association.

Conclusions:

  • Black and male infants experienced greater painful exposures than White and female infants.
  • Mother's own milk (MOM) intake showed a trend toward a protective effect, suggesting a potential role in individualized neonatal care strategies.
Abstract

Keywords:
composite pain scoresmother's own milkneurodevelopmentpainful and stressful exposurespreterm

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