Long-term effects of neonatal pain

  • Suellen M. Walker
    Correspondence
    Clinical Neurosciences (Pain Research), Level 4 PUW South, UCL GOS Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, United Kingdom.
    Affiliations
    Clinical Neurosciences (Pain Research), UCL Great Ormond Street Institute of Child Health, United Kingdom

    Department of Anaesthesia and Pain Medicine, Great Ormond Street Hospital NHS Foundation Trustvd, United Kingdom
    Search for articles by this author
Published:April 12, 2019DOI:https://doi.org/10.1016/j.siny.2019.04.005

      Abstract

      Pain experienced during neonatal intensive care management can influence neurodevelopmental outcome and the somatosensory and/or emotional components of pain response in later life. Alterations in biological factors (e.g. peripheral and central somatosensory function and modulation, brain structure and connectivity) and psychosocial factors (e.g. gender, coping style, mood, parental response) that influence pain have been identified in children and young adults born very preterm or extremely preterm. Earlier gestational age at birth and cumulative pain exposure from tissue-breaking procedures and/or neonatal surgery influence the degree of change. In neonatal rodents, repeated needle insertion or hindpaw incision identify developmentally-regulated and activity-dependent long term alterations in nociceptive processing, and the efficacy of novel or current analgesic interventions can be compared. As prior neonatal experience and sex may influence current pain experience or the risk of persistent pain, these factors should be considered within the biopsychosocial assessment and formulation of pain in later life.

      Keywords

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