Study attempts to predict venipuncture pain intensity

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Abstract:

INTRODUCTION: Children born very preterm display altered pain thresholds. Little is known about 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 in children born very preterm at school age.

METHODS: 56 children born very preterm (24-32 wk gestational age) at age 7.5 years, followed longitudinally from birth, and free of major neurodevelopmental impairments, underwent a blood collection by venipuncture. The children’s pain was self-reported using the Coloured Analog Scale and Facial Affective Scale. Parents completed the Child Behavior Checklist and State-Trait Anxiety Inventory. Pain exposure (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: 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 higher pain intensity.

CONCLUSION:
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.

Reference:

Valeri, B.O., Ranger, M., Chau, C.M., Cepeda, I.L., Synnes, A., Linhares, M.B. and Grunau, R.E. (2016) Neonatal Invasive Procedures Predict Pain Intensity at School Age in Children Born Very Preterm. The Clinical Journal of Pain. January 18th. [epub ahead of print].

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