Universität zu Köln

Mehler, Katrin, Giebisch, Christina, Abele, Julia, Roth, Bernhard and Huenseler, Christoph (2020). Pain response to vaccination in newborn infants of diabetic mothers. Early Hum. Dev., 149. CLARE: ELSEVIER IRELAND LTD. ISSN 1872-6232

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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.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Mehler, Katrin UNSPECIFIED UNSPECIFIED UNSPECIFIED Giebisch, Christina UNSPECIFIED UNSPECIFIED UNSPECIFIED Abele, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Roth, Bernhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Huenseler, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-317645
DOI:	10.1016/j.earlhumdev.2020.105139
Journal or Publication Title:	Early Hum. Dev.
Volume:	149
Date:	2020
Publisher:	ELSEVIER IRELAND LTD
Place of Publication:	CLARE
ISSN:	1872-6232
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language NEONATAL PROCEDURAL PAIN; INVASIVE PROCEDURES; SALIVARY CORTISOL; PRETERM; REACTIVITY; STRESS; BORN; AGE; BEHAVIOR; BIRTH Multiple languages Obstetrics & Gynecology; Pediatrics Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/31764