Universität zu Köln

Mehler, Katrin, Ulbrich, Lisa, Boerner, Sarah, Joachim, Alexander, Becker, Ingrid ORCID: 0000-0001-5829-3553, Roth, Bernhard and Huenseler, Christoph (2015). Multidimensional response to vaccination pain in very preterm, moderate- to-late preterm and full-term infants at age three months. Early Hum. Dev., 91 (3). S. 199 - 205. CLARE: ELSEVIER IRELAND LTD. ISSN 1872-6232

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Abstract

Background: Very early life pain exposure and stress induces alterations in the developing brain and leads to altered pain sensitivity. In premature infants with a history of numerous early postnatal adverse events, behavioral responsiveness and hypothalamic-pituitary-adrenal (HPA) axis reactivity may show alterations as well. Aims: We compared a multidimensional response to a painful situation (vaccination) in three month old infants. The study involved very preterm, moderate to late preterm infants and full-term infants with varying exposure to pain and stress within the first weeks of life. Study design: At the age of three months, we evaluated the infants' reactivity to intramuscular injections for immunization. Subjects: The study included 61 very preterm infants, 30 moderate to late preterm infants and 30 full-term infants. Outcome measures: We assessed heart rate recovery, Bernese pain Score and increase of salivary cortisol following vaccination. We also evaluated the flexor withdrawal reflex threshold as well as Prechtl's General Movements. Secondly, we assessed factors potentially influencing pain reactivity such as exposure to pain/stress, gender, use of steroids or opioids and mechanical ventilation. Results: Very preterm, moderate to late preterm and full-term infants showed different reactivity to pain in all analyzed aspects. Very preterm infants showed a lower level of behavioral and physiologic reactivity and exposure to pain/stress predicted lower cortisol increase. Conclusion: At three months of age, very preterm infants show an altered level of HPA axis reactivity. Efforts aiming at minimizing pain and stress in premature infants should be taken. (C) 2015 Elsevier Ireland Ltd. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Mehler, Katrin UNSPECIFIED UNSPECIFIED UNSPECIFIED Ulbrich, Lisa UNSPECIFIED UNSPECIFIED UNSPECIFIED Boerner, Sarah UNSPECIFIED UNSPECIFIED UNSPECIFIED Joachim, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Becker, Ingrid UNSPECIFIED orcid.org/0000-0001-5829-3553 UNSPECIFIED Roth, Bernhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Huenseler, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-405550
DOI:	10.1016/j.earlhumdev.2015.01.011
Journal or Publication Title:	Early Hum. Dev.
Volume:	91
Number:	3
Page Range:	S. 199 - 205
Date:	2015
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; PITUITARY-ADRENAL AXIS; LOW GESTATIONAL-AGE; BRAIN-DEVELOPMENT; PREMATURE NEWBORNS; WITHDRAWAL REFLEX; BASAL CORTISOL; STRESS; BEHAVIOR; BORN Multiple languages Obstetrics & Gynecology; Pediatrics Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/40555