Neonatal procedural pain exposure predicts lower cortisol and behavioral reactivity in preterm infants in the NICU

Ruth E Grunau, Liisa Holsti, David W Haley, Tim Oberlander, Joanne Weinberg, Alfonso Solimano, Michael F Whitfield, Colleen Fitzgerald, Wayne Yu

Research output: Contribution to journalArticle

231 Citations (Scopus)

Abstract

Data from animal models indicate that neonatal stress or pain can permanently alter subsequent behavioral and/or physiological reactivity to stressors. However, cumulative effects of pain related to acute procedures in the neonatal intensive care unit (NICU) on later stress and/or pain reactivity has received limited attention. The objective of this study is to examine relationships between prior neonatal pain exposure (number of skin breaking procedures), and subsequent stress and pain reactivity in preterm infants in the NICU. Eighty-seven preterm infants were studied at 32 (+/-1 week) postconceptional age (PCA). Infants who received analgesia or sedation in the 72 h prior to each study, or any postnatal dexamethasone, were excluded. Outcomes were infant responses to two different stressors studied on separate days in a repeated measures randomized crossover design: (1) plasma cortisol to stress of a fixed series of nursing procedures; (2) behavioral (Neonatal Facial Coding System; NFCS) and cardiac reactivity to pain of blood collection. Among infants born
Original languageEnglish
Pages (from-to)293-300
Number of pages8
JournalPain
Volume113
Issue number3
DOIs
Publication statusPublished - 2005

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