The DOI matches its Crossref record; 46 of the 46 references it cites were found in a registry or an index.
Neonatal procedural pain exposure predicts lower cortisol and behavioral reactivity in preterm infants in the NICU
Open accessAbstract
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 weeks) 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 ≤28 weeks gestational age (GA), but not 29–32 weeks GA, higher cumulative neonatal procedural pain exposure was related to lower cortisol response to stress and to lower facial (but not autonomic) reactivity to pain, at 32 weeks PCA, independent of early illness severity and morphine exposure since birth. Repeated neonatal procedural pain exposure among neurodevelopmentally immature preterm infants was associated with down-regulation of the hypothalamic–pituitary–adrenal axis, which was not counteracted with morphine. Differential effects of early pain on development of behavioral, physiologic and hormonal systems warrant further investigation.
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Cites
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“…to stressors in ELGA preterm infants at 8 months who had the most exposure to painful procedures since birth are consistent with those found in animal models of maternal separation stress, which reported sensitization of the HPA axis to subsequent stressors (e.g. Plotsky and Meaney, 1993).”
MethodPain expression in neonates: facial action and cry
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Self-citationEarly experience alters brain function and structure
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Transfer function analysis of the circulation: unique insights into cardiovascular regulation
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Long-term behavioral and neuroendocrine adaptations to adverse early experience
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Do early‐life events permanently alter behavioral and hormonal responses to stressors?
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Outcomes at School Age after Postnatal Dexamethasone Therapy for Lung Disease of Prematurity
Yeh, T. F., Lin, Y. J., Lin, H. C., Huang, C. C., Hsieh, W. S., Lin, C. H., & Tsai, C. H. (2004) · New England Journal of Medicine · doi:10.1056/nejmoa032089 · Cited by 596
Cited by
Grunau, R. E., Whitfield, M. F., Petrie-Thomas, J., Synnes, A. R., Cepeda, I. L., Keidar, A., Rogers, M., MacKay, M., Hubber-Richard, P., & Johannesen, D. (2009) · Pain · doi:10.1016/j.pain.2009.02.014 · Cited by 502
Self-citationEckstein Grunau, R. (2013) · Rambam Maimonides Medical Journal · doi:10.5041/rmmj.10132 · Cited by 353
Grunau, R. E., Haley, D. W., Whitfield, M. F., Weinberg, J., Yu, W., & Thiessen, P. (2007) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2006.10.053 · Cited by 300
Self-citationRanger, M., Chau, C. M. Y., Garg, A., Woodward, T. S., Beg, M. F., Bjornson, B., Poskitt, K., Fitzpatrick, K., Synnes, A. R., Miller, S. P., et al. (2013) · PLoS ONE · doi:10.1371/journal.pone.0076702 · Cited by 288
Self-citationBurke, N. N., Finn, D. P., McGuire, B. E., & Roche, M. (2017) · Journal of Neuroscience Research · doi:10.1002/jnr.23802 · Cited by 268
Metadata
- Authors
- Grunau, R. E., Holsti, L., Haley, D. W., Oberlander, T., Weinberg, J., Solimano, A., Whitfield, M. F., Fitzgerald, C., & Yu, W.
- Venue
- Pain
- Published
- 2005-02
- Volume
- 113
- Issue
- 3
- Pages
- 293-300
- ISSN
- 0304-3959 (ISSN-L)
- OpenAlex
- W2040112185
- Cited by
- 393
- References
- 46
- FWCI
- 9.16
- Type
- journal article
- Language
- en
- Open access
- green
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- Grunau, R. E., Holsti, L., Haley, D. W., Oberlander, T., Weinberg, J., Solimano, A., Whitfield, M. F., Fitzgerald, C., & Yu, W. (2005). Neonatal procedural pain exposure predicts lower cortisol and behavioral reactivity in preterm infants in the NICU. Pain. https://doi.org/10.1016/j.pain.2004.10.020
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