Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Science, University of Copenhagen, Oster Farimagsgade 5, bd. 24, DK-1014, Copenhagen K, Denmark.
Eur J Pediatr. 2024 Jan;183(1):203-211. doi: 10.1007/s00431-023-05264-x. Epub 2023 Oct 20.
Repeated exposure to pain and stress in early life may cause alterations in pain sensitivity later in life. Children born preterm are often exposed to painful invasive procedures. This study aimed to explore the relationship between being born preterm and self-report of spinal pain in pre-adolescence. This prospective study was based on the Danish National Birth Cohort and consisted of 47,063 11-14-year-olds. Data from the Danish National Birth Cohort were linked with national registers through Statistics Denmark. Analyses were performed as multiple logistic regression models estimating odds ratios and 95% confidence intervals. Spinal pain (neck, mid back, and/or low back pain) was assessed using a subdivision of the Young Spine Questionnaire. Severe spinal pain was defined as having pain often or once in a while with an intensity of four to six on the Revised Faces Pain Scale. Inverse probability weighting was used to account for potential selection bias. Girls born very preterm (< 34 full weeks of gestation) were less likely to report spinal pain (OR: 0.60; 95% CI: 0.40-0.93) compared with those term-born. The associations were weaker when examining moderate to severe spinal pain and when examining the three spinal regions separately. None of these was statistically significant.
We found no associations for boys. In conclusion, this study indicates that girls born very preterm are seemingly less likely to have severe spinal pain in pre-adolescence than girls born at term.
• Spinal pain is one of the largest disease burdens globally, and the evidence regarding the etiology of spinal pain in children and adolescents is limited. • Repeated exposure to pain and stress in early life (i.e., being preterm) may cause alterations in pain sensitivity later in life.
• Girls born very preterm (< 34 full weeks of gestation) seem less likely to report severe spinal pain in pre-adolescence compared with girls born at full term. • There is no association between gestational age and later experience of spinal pain in pre-adolescent boys.
生命早期反复遭受疼痛和压力可能会导致日后疼痛敏感性改变。早产儿通常会经历痛苦的有创性操作。本研究旨在探讨早产儿与青少年前期自述的脊柱疼痛之间的关系。这项前瞻性研究基于丹麦全国出生队列，共纳入 47063 名 11-14 岁儿童。丹麦全国出生队列的数据通过丹麦统计局与全国登记册相链接。采用多项逻辑回归模型进行分析，估计比值比和 95%置信区间。脊柱疼痛（颈部、中背部和/或下背部疼痛）使用青少年脊柱问卷的细分进行评估。严重脊柱疼痛定义为疼痛频率为经常或偶尔，修订面部疼痛量表的强度为 4-6。使用逆概率加权法来考虑潜在的选择偏差。与足月出生的婴儿相比，极早产儿（<34 周妊娠）女孩报告脊柱疼痛的可能性较小（OR：0.60；95%CI：0.40-0.93）。当检查中度至重度脊柱疼痛和分别检查三个脊柱区域时，关联减弱，但均无统计学意义。
我们未发现男孩存在关联。总之，本研究表明，与足月出生的女孩相比，极早产儿出生的女孩在青少年前期似乎不太可能出现严重的脊柱疼痛。
• 脊柱疼痛是全球最大的疾病负担之一，关于儿童和青少年脊柱疼痛病因的证据有限。• 生命早期反复遭受疼痛和压力（即早产）可能会导致日后疼痛敏感性改变。
• 与足月出生的女孩相比，极早产儿（<34 周妊娠）出生的女孩在青少年前期自述严重脊柱疼痛的可能性较低。• 未发现男孩的胎龄与青少年前期脊柱疼痛发生之间存在关联。
