van Dokkum Nienke H, de Kroon Marlou L A, Reijneveld Sijmen A, Bos Arend F
Department of Pediatrics Division of Neonatology Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen Groningen the Netherlands.
Department of Health Sciences University Medical Center Groningen, University of Groningen Groningen the Netherlands.
Paediatr Neonatal Pain. 2021 May 11;3(2):59-67. doi: 10.1002/pne2.12053. eCollection 2021 Jun.
We aimed to compare ratings of self-reported and parent-reported pain sensitivity between early preterm (EP), moderately-late preterm (MLP), and full-term (FT) adolescents. For EP adolescents, we aimed to determine whether pain sensitivity was associated with early-life events. EP (n = 68, response rate 47.4%), MLP (n = 128, response rate 33.0%), and FT (n = 78, response rate 31.1%) adolescents and their parents (n = 277) answered an author-generated question on pain sensitivity at 14-15 years of age within a community-based cohort study. Differences between groups were determined using the chi-square test for trends. For EP adolescents, we assessed associations of treatment modalities (inotrope treatment, mechanical ventilation, and C-section) and neonatal morbidities (sepsis/necrotizing enterocolitis, small-for-gestational age status, asphyxia, and cerebral pathologies) with adolescent pain sensitivity using logistic regression analyses. Increased pain sensitivity was reported by 18% of EP adolescents, compared with 12% of MLP adolescents, and 7% of FT adolescents ( = 0.033). Parent-reported pain sensitivity did not differ by gestational age group. For EP adolescents, inotrope treatment was associated with increased pain sensitivity (odds ratio, 5.00, 95% confidence interval, 1.23-20.4, = 0.025). No other neonatal treatment modalities or morbidities were associated with pain sensitivity in adolescence. In conclusion, we observed higher proportions of increased pain sensitivity for EP and MLP adolescents. Physicians treating preterm adolescents should be aware of altered pain sensitivity.
我们旨在比较极早早产儿（EP）、中晚期早产儿（MLP）和足月儿（FT）青少年自我报告和家长报告的疼痛敏感性评分。对于极早早产儿青少年，我们旨在确定疼痛敏感性是否与早期生活事件相关。在一项基于社区的队列研究中，极早早产儿（n = 68，应答率47.4%）、中晚期早产儿（n = 128，应答率33.0%）和足月儿（n = 78，应答率31.1%）青少年及其家长（n = 277）回答了一个由作者提出的关于14 - 15岁时疼痛敏感性的问题。使用趋势卡方检验确定组间差异。对于极早早产儿青少年，我们使用逻辑回归分析评估治疗方式（血管活性药物治疗、机械通气和剖宫产）和新生儿疾病（败血症/坏死性小肠结肠炎、小于胎龄儿状态、窒息和脑部病变）与青少年疼痛敏感性的关联。据报告，18%的极早早产儿青少年疼痛敏感性增加，相比之下，中晚期早产儿青少年为12%，足月儿青少年为7%（P = 0.033）。家长报告的疼痛敏感性在不同孕周组之间没有差异。对于极早早产儿青少年，血管活性药物治疗与疼痛敏感性增加相关（比值比，5.00，95%置信区间，1.23 - 20.4，P = 0.025）。没有其他新生儿治疗方式或疾病与青少年期的疼痛敏感性相关。总之，我们观察到极早早产儿和中晚期早产儿青少年中疼痛敏感性增加的比例更高。治疗早产青少年的医生应意识到疼痛敏感性的改变。
