Universität zu Köln

Weber, Julia Christina (2021). Multidimensionale Analyse des Schmerzverhaltens reifgeborener Kinder diabetischer Mütter im Alter von 3 Monate. PhD thesis, Universität zu Köln.

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Abstract

Background: Response to pain is altered in infants who were exposed to pain- and stressful events in the neonatal period. Infants of diabetic mothers receive several heel sticks after birth for measuring blood glucose and thus may show changes in their behavioral and physiologic response to pain. Moreover, maternal hyperglycemia may alter activity of the hypothalamic pituitary adrenal (HPA) axis reactivity. Study design: In total, 43 infants of diabetic mothers and 30 control infants were included into the study. Response to pain was assessed at 3 months of age following two intramuscular injections for vaccination. We assessed behavioral (Bernese pain scale), physiologic (heart rate) and hormonal (salivary cortisol) pain response to vaccination as well as spinal sensitization (flexion withdrawal reflex). Results: Infants of diabetic mothers received a median number of 5 [4-19] painful events compared to 1 [1-3] in the control group. Heart rate reactivity differed significantly between groups. Infants of diabetic mothers had higher peaks (p = 0.002) and needed more time to recover to baseline (p < 0.001). Moreover, infants of diabetic mothers showed higher peak cortisol (p = 0.001) and a higher relative cortisol increase (p = 0.015). Flexor withdrawal reflex thresholds were significantly lower in infants of diabetic mothers (p = 0.003). Conclusion: The increase of physiologic and hormonal responses to pain in infants of diabetic mothers is probably caused by repeated painful events and an altered metabolic profile. Keywords: Behavioral pain response; Cortisol reactivity; HPA axis; Infants of diabetic mothers; Neonatal pain; Vaccination pain.

Item Type:	Thesis (PhD thesis)
Creators:	Creators Email ORCID ORCID Put Code Weber, Julia Christina cweber22@gmx.net UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-630655
Date:	20 September 2021
Language:	German
Faculty:	Faculty of Medicine
Divisions:	Faculty of Medicine > Kinder- und Jugendmedizin
Subjects:	Medical sciences Medicine
Uncontrolled Keywords:	Keywords Language Schmerzverhalten, Diabetes, reifgeboren, HPA-Achse, Kortisol UNSPECIFIED
Date of oral exam:	20 September 2021
Referee:	Name Academic Title Mehler, Katrin Priv.-Doz. Dr. Hucho, Tim Univ.-Prof. Dr. rer. nat.
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/63065