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Neonatal Invasive Procedures Predict Pain Intensity at School Age in Children Born Very Preterm

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Introduction:

Children born very preterm display altered pain thresholds. Little is known about the neonatal clinical and psychosocial factors associated with their later pain perception.

Objective:

We aimed to examine whether the number of neonatal invasive procedures, adjusted for other clinical and psychosocial factors, was associated with self-ratings of pain during a blood collection procedure at school age in children born very preterm.

Materials and Methods:

56 children born very preterm (24 to 32 weeks gestational age), followed longitudinally from birth, and free of major neurodevelopmental impairments underwent a blood collection by venipuncture at age 7.5 years. The children’s pain was self-reported using the Coloured Analog Scale and the Facial Affective Scale. Parents completed the Child Behavior Checklist and the State-Trait Anxiety Inventory. Pain exposure (the number of invasive procedures) and clinical factors from birth to term-equivalent age were obtained prospectively. Multiple linear regression was used to predict children’s pain self-ratings from neonatal pain exposure after adjusting for neonatal clinical and concurrent psychosocial factors.

Results:

A greater number of neonatal invasive procedures and higher parent trait-anxiety were associated with higher pain intensity ratings during venipuncture at age 7.5 years. Fewer surgeries and lower concurrent child externalizing behaviors were associated with a higher pain intensity.

Conclusions:

In very preterm children, exposure to neonatal pain was related to altered pain self-ratings at school age, independent of other neonatal factors. Neonatal surgeries and concurrent psychosocial factors were also associated with pain ratings.
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Keywords: behavior; child; pain; parents; preterm infant

Document Type: Research Article

Affiliations: 1: Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil, Child & Family Research Institute 2: Child & Family Research Institute, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada 3: Child & Family Research Institute 4: Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil

Publication date: December 1, 2016

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