The effect of early procedural pain in preterm infants on the maturation of electroencephalogram and heart rate variability
Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the International Association for the Study of Pain..
ABSTRACT: Preterm infants show a higher incidence of cognitive, social, and behavioral problems, even in the absence of major medical complications during their stay in the neonatal intensive care unit (NICU). Several authors suggest that early-life experience of stress and procedural pain could impact cerebral development and maturation resulting in an altered development of cognition, behavior, or motor patterns in later life. However, it remains very difficult to assess this impact of procedural pain on physiological development. This study describes the maturation of electroencephalogram (EEG) signals and heart rate variability in a prospective cohort of 92 preterm infants (<34 weeks gestational age) during their NICU stay. We took into account the number of noxious, ie, skin-breaking, procedures they were subjected in the first 5 days of life, which corresponded to a median age of 31 weeks and 4 days. Using physiological signal modelling, this study shows that a high exposure to early procedural pain, measured as skin-breaking procedures, increased the level of discontinuity in both EEG and heart rate variability in preterm infants. These findings have also been confirmed in a subset of the most vulnerable preterm infants with a gestational age lower than 29 weeks. We conclude that a high level of early pain exposure in the NICU increases the level of functional dysmaturity, which can ultimately impact preterm infants' future developmental outcome.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:162 |
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| Enthalten in: |
Pain - 162(2021), 5 vom: 01. Mai, Seite 1556-1566 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Lavanga, Mario [VerfasserIn] |
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| Anmerkungen: |
Date Completed 19.05.2021 Date Revised 18.08.2023 published: Print Citation Status MEDLINE |
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| doi: |
10.1097/j.pain.0000000000002125 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM316786845 |
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| 245 | 1 | 4 | |a The effect of early procedural pain in preterm infants on the maturation of electroencephalogram and heart rate variability |
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| 500 | |a Date Revised 18.08.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the International Association for the Study of Pain. | ||
| 520 | |a ABSTRACT: Preterm infants show a higher incidence of cognitive, social, and behavioral problems, even in the absence of major medical complications during their stay in the neonatal intensive care unit (NICU). Several authors suggest that early-life experience of stress and procedural pain could impact cerebral development and maturation resulting in an altered development of cognition, behavior, or motor patterns in later life. However, it remains very difficult to assess this impact of procedural pain on physiological development. This study describes the maturation of electroencephalogram (EEG) signals and heart rate variability in a prospective cohort of 92 preterm infants (<34 weeks gestational age) during their NICU stay. We took into account the number of noxious, ie, skin-breaking, procedures they were subjected in the first 5 days of life, which corresponded to a median age of 31 weeks and 4 days. Using physiological signal modelling, this study shows that a high exposure to early procedural pain, measured as skin-breaking procedures, increased the level of discontinuity in both EEG and heart rate variability in preterm infants. These findings have also been confirmed in a subset of the most vulnerable preterm infants with a gestational age lower than 29 weeks. We conclude that a high level of early pain exposure in the NICU increases the level of functional dysmaturity, which can ultimately impact preterm infants' future developmental outcome | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 700 | 1 | |a Bollen, Bieke |e verfasserin |4 aut | |
| 700 | 1 | |a Caicedo, Alexander |e verfasserin |4 aut | |
| 700 | 1 | |a Dereymaeker, Anneleen |e verfasserin |4 aut | |
| 700 | 1 | |a Jansen, Katrien |e verfasserin |4 aut | |
| 700 | 1 | |a Ortibus, Els |e verfasserin |4 aut | |
| 700 | 1 | |a Van Huffel, Sabine |e verfasserin |4 aut | |
| 700 | 1 | |a Naulaers, Gunnar |e verfasserin |4 aut | |
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