Pain-associated stressor exposure and neuroendocrine values for premature infants in neonatal intensive care.
Recurrent stress during neonatal intensive care taxes the adaptive capacity of the premature infant and may be a risk factor for suboptimal developmental outcomes. This research used a descriptive, cross-sectional design and a life course perspective to examine the relationship between resting adrenocorticoid values at 37 postmenstrual weeks of age and cumulative pain-associated stressor exposure in prematurely born infants. Subjects were 59 infants born at under 35 completed weeks of gestation, who were at least 2 weeks of age, and who had been cared for in the NICU since birth. No significant relationships were identified between cortisol values and any of the study variables (number of skin breaking procedures, hours of assisted ventilation, gestational age at birth, exposure to antenatal steroids, history of severe academia, birthweight, days of age to attain birthweight, weight at testing, days of age at testing, recent pain-associated procedures, and 17-OHP value). A significant negative correlation (Spearman rank, one-tailed) between the number of skin-breaking procedures and 17-OHP values was identified (r = -.232, p = .039). Recurrent pain-associated stressor exposure may be a more important factor in explaining the variance of 17-OHP values at 37 postmenstrual weeks of age than birthweight, gestational age, or chronological age.
School of Nursing, Stony Brook University, Health Sciences Center-Level 2, Office 247, Stony Brook, NY, 11794. annie.rohan@stonybrook.edu.
Annie J
AJ
Rohan
D003430:Cross-Sectional Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007231:Infant, Newborn; D007234:Infant, Premature; D015931:Intensive Care, Neonatal; D008297:Male; D010146:Pain / Q000097:blood*; D013312:Stress, Physiological / Q000502:physiology*
D006854:Hydrocortisone
17-hydroxyprogesterone; allostasis; allostatic load; cortisol; neonatal intensive care; neonate; neurodevelopment; pain; pain-associated stressor; premature infant; procedural pain; stress