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Pain sensitivity and temperament in extremely low-birth-weight premature toddlers and preterm and full-term controls
Ruth V E Grunau1, Michael F Whitfield, Julianne H Petrie
1British Columbia Children's Hospital, Vancouver, BC V6H 3V4 Canada The University of British Columbia, Vancouver, BC V6H 3V4 Canada.
Insights
Parents perceive extremely low-birth-weight (ELBW) toddlers as less sensitive to pain. This perception differs based on birth weight, with the lowest birth weight group showing no relation between temperament and pain sensitivity.
Area of Science:
- Neonatal Medicine
- Developmental Psychology
- Pain Research
Background:
- Extremely low-birth-weight (ELBW) infants undergo numerous painful medical interventions.
- These interventions may impact later pain responses and sensitivity.
- Understanding pain perception in ELBW survivors is crucial for long-term care.
Purpose of the Study:
- To assess parent-reported pain sensitivity in ELBW toddlers at 18 months corrected age.
- To investigate the relationship between pain sensitivity, child temperament, and parenting style in ELBW and control groups.
- To identify differences in pain perception related to birth weight categories.
Main Methods:
- Parental ratings of pain sensitivity were collected for ELBW infants (two birth weight groups: <801g and 801-1000g).
- Control groups included heavier preterm (1500-2499g) and full-birth-weight (FBW) infants (>2500g).
- Statistical analyses examined correlations between pain sensitivity, temperament, and parenting style across groups.
Main Results:
- ELBW toddlers were rated by parents as significantly less sensitive to pain compared to both heavier preterm and FBW control groups.
- The relationship between temperament and pain sensitivity varied: strong in FBW, moderate in heavier preterm and ELBW (801-1000g), and absent in ELBW (<801g).
- Parenting style did not mediate pain sensitivity ratings.
Conclusions:
- Parents perceive distinct differences in pain behavior among ELBW toddlers compared to heavier preterm and FBW children.
- Pain perception and its relation to temperament are significantly influenced by birth weight, particularly in the lowest ELBW category.
- Further longitudinal studies are needed to understand pain behavior development in hospitalized infants.
Abstract:
High-technology medical care of extremely low-birth-weight (ELBW) infants (< 1001 g) involves repeated medical interventions which are potentially painful and may later affect reaction to pain. At 18 months corrected age (CCA), we examined parent ratings of pain sensitivity and how pain sensitivity ratings related to child temperament and parenting style in 2 groups of ELBW children (49 with a birth weight of 480-800 g and 75 with a birth weight of 801-1000 g) and 2 control groups (42 heavier preterm (1500-2499 g) and 29 full-birth-weight (FBW) children (> 2500 g). Both groups of ELBW toddlers were rated by parents as significantly lower in pain sensitivity compared with both control groups. The relationships between child temperament and pain sensitivity rating varied systematically across the groups. Temperament was strongly related to rated pain sensitivity in the FBW group, moderately related in the heavier preterm and ELBW 801-1000 g groups, and not related in the lowest birth-weight group (< 801 g). Parental style did not mediate ratings of pain sensitivity. The results suggest that parents perceive differences in pain behavior of ELBW toddlers compared with heavier preterm and FBW toddlers, especially for those less than 801 g. Longitudinal research into the development of pain behavior for infants who experience lengthy hospitalization is warranted.