Christ-Jan J L M van Ganzewinkel1, Jasper V Been2, Inge Verbeek3, Tera Boelen van der Loo4, Sylvia M van der Pal4, Boris W Kramer5, Peter Andriessen3. 1. Department of Pediatrics, Division of Neonatology, Máxima Medical Centre, De Run 4600, 5504 MB Veldhoven, The Netherlands. Electronic address: c.vanganzewinkel@mmc.nl. 2. Division of Neonatology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands; Department of Pediatrics, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands; Department of Obstetrics and Gynaecology, Erasmus MC-Sophia Children's Hospital, Wytemaweg 80, 3015 CN, Rotterdam, Netherlands. 3. Department of Pediatrics, Division of Neonatology, Máxima Medical Centre, De Run 4600, 5504 MB Veldhoven, The Netherlands; Department of Pediatrics, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands. 4. TNO Quality of Life, Prevention and Health, Schipholweg 77-89, 2316 ZL Leiden, The Netherlands. 5. Department of Pediatrics, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands; School for Oncology and Developmental Biology (GROW), Maastricht University Medical Centre, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands; School of Mental Health and Neuroscience (MHeNS), Maastricht University Medical Centre, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands.
Abstract
BACKGROUND: Data on long-term consequences of neonatal pain is limited. AIM: To assess whether perinatal factors, later pain experience and pain coping strategies are associated with altered pain threshold, pain tolerance and pain intensity in adolescents born preterm. STUDY DESIGN: Observational, longitudinal study (Project on Preterm and SGA-infants, POPS-19). SUBJECTS: We analyzed data of 412 adolescents at the age of 19years, who were born at a gestational age<32weeks or with a birth weight<1500g. OUTCOME MEASURES: Participants performed a standardized cold pressor test to assess pain threshold, tolerance and intensity. Furthermore, they completed a pain coping questionnaire (PCQ). RESULTS: In univariate analysis, female gender and necrotizing enterocolitis (NEC) were associated with lower pain tolerance, indicated by reaching the ceiling time of 180s in ice water (females 19% vs males 29%, NEC 7% vs no NEC 25%). Female gender was associated with higher pain intensity (mean difference 0.58; 95%CI 0.21; 0.95) and lower pain threshold (log rank test p 0.007). In a multivariate Cox regression analyses, emotion focused avoidance pain coping style was significantly associated with lower pain threshold (hazard ratio HR 1.38; 95%CI 1.02; 1.87) and pain tolerance (HR 1.72; 95%CI 1.21; 2.42). NEC was significantly associated with lower pain threshold (HR 1.47; 95%CI 1.01; 2.14) and pain tolerance (HR 1.63; 95%CI 1.09; 2.41). CONCLUSION: In adolescence, maladaptive pain coping strategy was associated with lower pain threshold, pain tolerance and higher pain intensity. NEC was associated with altered pain response in adolescents born preterm.
BACKGROUND: Data on long-term consequences of neonatal pain is limited. AIM: To assess whether perinatal factors, later pain experience and pain coping strategies are associated with altered pain threshold, pain tolerance and pain intensity in adolescents born preterm. STUDY DESIGN: Observational, longitudinal study (Project on Preterm and SGA-infants, POPS-19). SUBJECTS: We analyzed data of 412 adolescents at the age of 19years, who were born at a gestational age<32weeks or with a birth weight<1500g. OUTCOME MEASURES: Participants performed a standardized cold pressor test to assess pain threshold, tolerance and intensity. Furthermore, they completed a pain coping questionnaire (PCQ). RESULTS: In univariate analysis, female gender and necrotizing enterocolitis (NEC) were associated with lower pain tolerance, indicated by reaching the ceiling time of 180s in ice water (females 19% vs males 29%, NEC 7% vs no NEC 25%). Female gender was associated with higher pain intensity (mean difference 0.58; 95%CI 0.21; 0.95) and lower pain threshold (log rank test p 0.007). In a multivariate Cox regression analyses, emotion focused avoidance pain coping style was significantly associated with lower pain threshold (hazard ratio HR 1.38; 95%CI 1.02; 1.87) and pain tolerance (HR 1.72; 95%CI 1.21; 2.42). NEC was significantly associated with lower pain threshold (HR 1.47; 95%CI 1.01; 2.14) and pain tolerance (HR 1.63; 95%CI 1.09; 2.41). CONCLUSION: In adolescence, maladaptive pain coping strategy was associated with lower pain threshold, pain tolerance and higher pain intensity. NEC was associated with altered pain response in adolescents born preterm.