351. Neonatal procedural pain exposure predicts lower cortisol and behavioral reactivity in preterm infants in the NICU.
- Author
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Grunau RE, Holsti L, Haley DW, Oberlander T, Weinberg J, Solimano A, Whitfield MF, Fitzgerald C, and Yu W
- Subjects
- Blood Pressure physiology, Cross-Over Studies, Electroencephalography methods, Female, Heart Rate physiology, Humans, Infant, Infant Behavior drug effects, Infant, Newborn, Infant, Very Low Birth Weight physiology, Male, Morphine therapeutic use, Narcotics therapeutic use, Pain drug therapy, Pain Measurement methods, Predictive Value of Tests, Radioimmunoassay methods, Stress, Physiological physiopathology, Face physiopathology, Hydrocortisone blood, Infant Behavior physiology, Intensive Care Units, Neonatal statistics & numerical data, Pain physiopathology, Premature Birth physiopathology
- 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
- Published
- 2005
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