BC Children's Hospital Research Institute, Vancouver, BC, Canada.
Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.
Dev Psychobiol. 2021 Jul;63(5):915-930. doi: 10.1002/dev.22079. Epub 2020 Dec 29.
Children born preterm display altered sensory processing, which may manifest as hyper- and/or hypo-sensitivity to sensory information. In this vulnerable population, exposure to neonatal pain-related stress is associated with altered stress regulation, as indexed by alterations in cortisol levels. It is unknown whether sensory processing behaviors are also affected by early life adversity, and whether dysregulated cortisol is related to sensory processing problems in preterm children. We examined relationships between neonatal pain-related stress, sensory processing profiles and cortisol levels at age 4 years, and whether pathways were sex-specific. In a longitudinal prospective cohort study, N = 146 infants born 24-32 weeks gestational age were recruited from BC Women's Hospital, Vancouver, BC, Canada; neonatal factors were collected from daily chart review. At age 4 years, saliva to assay cortisol was collected three times across cognitive assessment (pre-test, during, end) and parents completed the Short Sensory Profile questionnaire. Using generalized linear modeling, independent of other neonatal factors, higher number of invasive procedures (pain/stress) was associated with more sensory processing problems (total, hypo- and hyper-sensitivity) for girls only. After accounting for neonatal factors, greater cortisol output across the assessment was associated with more total sensory processing problems in girls only, and hypersensitivity to sensory input in both boys and girls. Findings suggest that in children born very preterm, how a child responds to sensory input and cortisol reactivity to stress are related but may have different precursors. Girls may be somewhat more susceptible to neonatal pain-related stress exposure in relation to sensory processing at preschool age.
早产儿表现出感觉处理的改变，这可能表现为对感觉信息的超敏或低敏。在这个脆弱的人群中，与新生儿疼痛相关的应激暴露与应激调节的改变有关，表现为皮质醇水平的改变。目前尚不清楚感觉处理行为是否也受到早期生活逆境的影响，以及皮质醇失调是否与早产儿的感觉处理问题有关。我们研究了新生儿疼痛相关应激、4 岁时的感觉处理特征和皮质醇水平之间的关系，以及这些途径是否具有性别特异性。在一项纵向前瞻性队列研究中，我们从加拿大不列颠哥伦比亚省温哥华的 BC 妇女医院招募了 146 名 24-32 周龄的婴儿；从每日图表审查中收集了新生儿因素。在 4 岁时，通过认知评估（前测、进行中、结束时）采集了三次唾液来检测皮质醇，父母完成了简短感觉特征问卷。使用广义线性模型，在不考虑其他新生儿因素的情况下，更多的侵入性操作（疼痛/应激）与女孩的更多感觉处理问题（总体、低敏和超敏）相关。在考虑了新生儿因素后，评估过程中皮质醇分泌量的增加与女孩的总感觉处理问题以及男孩和女孩对感觉输入的超敏反应有关。研究结果表明，在极早产儿中，儿童对感觉输入的反应方式和皮质醇对压力的反应性是相关的，但可能有不同的前兆。在与学龄前感觉处理相关的情况下，女孩可能更容易受到与新生儿疼痛相关的应激暴露的影响。
