Iris Morag1, Ifat Rotem2, Mor Frisch3, Israel Hendler4, Michal J Simchen5, Leah Leibovitz6, Ayala Maayan-Metzger7, Tzipora Strauss6. 1. Department of Neonatology, The Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Israel. Electronic address: Iris.Morag@sheba.health.gov.il. 2. Sackler School of Medicine, Tel Aviv University, Israel. 3. Sackler School of Medicine, Tel Aviv University, Israel. Electronic address: morf@mail.tau.ac.il. 4. Sackler School of Medicine, Tel Aviv University, Israel; Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer, Israel. 5. Sackler School of Medicine, Tel Aviv University, Israel; Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer, Israel. Electronic address: michal.simchen@sheba.health.gov.il. 6. Department of Neonatology, The Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Israel. 7. Department of Neonatology, The Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Israel. Electronic address: ayala.maayan@sheba.health.gov.il.
Abstract
BACKGROUND: Extensive exposure of preterm infants to pain-related stress (PRS) at a time of physiological immaturity and rapid brain development may contribute to altered neurodevelopment. OBJECTIVE: To examine the relationship between early PRS and neurodevelopmental outcomes among low-risk very preterm infants at the age of one year corrected age (CA). METHODS: Participants included 107 infants born <32weeks gestational age (GA) and monitored prospectively at 12.5months CA. Excluded were infants with severe neonatal morbidities associated with impaired neurodevelopment. PRS documentation was performed via the number of skin-breaking procedures (SBP) and by the use of the neonatal infant stressor scale (NISS). Adjustment was made for early neonatal morbidities. RESULTS: Developmental outcomes among the study infants were within the norm (mean 100±11.03). Infants who underwent invasive mechanical ventilation (IMV) (n=31) were exposed to significantly more PRS than non-IMV infants (n=76) (p<0.000). Developmental outcomes were similar in both groups (99.7±11.1 vs. 100.8±11 p=0.63). Among IMV infants, increased exposure to PRS was associated with lower developmental scores independent of GA, gender or other sociodemographic factors. CONCLUSION: Increased exposure to PRS among low-risk preterm infants who underwent IMV is associated with lower developmental scores at 12.5month CA.
BACKGROUND: Extensive exposure of preterm infants to pain-related stress (PRS) at a time of physiological immaturity and rapid brain development may contribute to altered neurodevelopment. OBJECTIVE: To examine the relationship between early PRS and neurodevelopmental outcomes among low-risk very preterm infants at the age of one year corrected age (CA). METHODS:Participants included 107 infants born <32weeks gestational age (GA) and monitored prospectively at 12.5months CA. Excluded were infants with severe neonatal morbidities associated with impaired neurodevelopment. PRS documentation was performed via the number of skin-breaking procedures (SBP) and by the use of the neonatal infant stressor scale (NISS). Adjustment was made for early neonatal morbidities. RESULTS: Developmental outcomes among the study infants were within the norm (mean 100±11.03). Infants who underwent invasive mechanical ventilation (IMV) (n=31) were exposed to significantly more PRS than non-IMV infants (n=76) (p<0.000). Developmental outcomes were similar in both groups (99.7±11.1 vs. 100.8±11 p=0.63). Among IMV infants, increased exposure to PRS was associated with lower developmental scores independent of GA, gender or other sociodemographic factors. CONCLUSION: Increased exposure to PRS among low-risk preterm infants who underwent IMV is associated with lower developmental scores at 12.5month CA.