title: Pain coping strategies: Neonatal intensive care unit survivors in adolescence.
abstract: Data on long-term consequences of preterm birth on pain coping later in life are limited.
  
  
  
  To assess whether gestational age, birth weight and neonatal disease severity have effect on pain coping style in adolescents born preterm or with low birth weight.
  
  
  
  Observational, longitudinal study (Project On Preterm and SGA-infants, POPS-19).
  
  
  
  We analyzed data of 537 adolescents at the age of 19 years, who were born at a gestational age <32 weeks or with a birth weight <1500g.
  
  
  
  Participants completed the pain coping questionnaire (PCQ) that assesses pain coping strategies in three higher-order factors: approach ("to deal with pain"), problem-focused avoidance ("to disengage from pain") and emotion-focused avoidance ("expression of pain"). Furthermore, their pain coping effectiveness, pain controllability and emotional reactions to pain were assessed. All participants completed an IQ test.
  
  
  
  Univariate analysis showed no significant correlation between length of stay, sepsis and necrotizing enterocolitis and any of the higher-order factors. Approach was only correlated with IQ. Problem-focused avoidance was, in the multiple regression analysis (including gestational age, IVH and IQ), only correlated with IQ. For emotion-focused avoidance (including birth weight, SGA, IVH, respiratory support and IQ) three independent predictors remained: IVH was positively correlated, while respiratory support and IQ were negatively correlated with emotion-focused avoidance.
  
  
  
  Early neonatal characteristics and neonatal disease severity have limited effect on pain coping style in adolescence. Higher IQ was associated with the use of adaptive coping strategies, while maladaptive strategies were used less.
authors.affiliation: Department of Pediatrics, division of Neonatology, Máxima Medical Center, De Run 4600, 5504, MB, Veldhoven, The Netherlands. Electronic address: c.vanganzewinkel@mmc.nl.
authors.forename: Christ-Jan
authors.initials: CJ
authors.lastname: van Ganzewinkel
authors.affiliation: Department of Neonatology, Erasmus MC-Sophia Children's Hospital, Wytemaweg 80, 3015, CN, Rotterdam, The Netherlands; Department of Pediatrics, Maastricht University Medical Center, P. Debyelaan 25, 6229, HX, Maastricht, The Netherlands; School for Public Health and Primary Care, Maastricht University, Universiteitssingel 40, 6229, ER, Maastricht, The Netherlands. Electronic address: j.been@erasmusmc.nl.
authors.forename: Jasper V
authors.initials: JV
authors.lastname: Been
authors.affiliation: MMC Academie; Máxima Medical Center, De Run 4600, 5504, MB, Veldhoven, The Netherlands. Electronic address: j.dieleman@mmc.nl.
authors.forename: Jeanne P
authors.initials: JP
authors.lastname: Dieleman
authors.affiliation: Department of Psychology, Máxima Medical Center, De Run 4600, 5504, MB, Veldhoven, The Netherlands. Electronic address: t.katgert@mmc.nl.
authors.forename: Titia
authors.initials: T
authors.lastname: Katgert
authors.affiliation: TNO Quality of Life, Prevention and Health, Schipholweg 77-89, 2316, ZL, Leiden, The Netherlands. Electronic address: boelen@introweb.nl.
authors.forename: Tera
authors.initials: T
authors.lastname: Boelen-van der Loo
authors.affiliation: TNO Quality of Life, Prevention and Health, Schipholweg 77-89, 2316, ZL, Leiden, The Netherlands. Electronic address: sylvia.vanderpal@tno.nl.
authors.forename: Sylvia M
authors.initials: SM
authors.lastname: van der Pal
authors.affiliation: Intensive Care, Department of Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, Wytemaweg 80, 3015, CN, Rotterdam, The Netherlands. Electronic address: m.vandijk.3@erasmusmc.nl.
authors.forename: Monique
authors.initials: M
authors.lastname: van Dijk
authors.affiliation: Department of Pediatrics, Maastricht University Medical Center, P. Debyelaan 25, 6229, HX, Maastricht, The Netherlands; School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center, Universiteitssingel 40, 6229, ER, Maastricht, The Netherlands; School of Mental Health and Neuroscience (MHeNS), Maastricht University Medical Center, Universiteitssingel 40, 6229, ER, Maastricht, The Netherlands. Electronic address: b.kramer@maastrichtuniversity.nl.
authors.forename: Boris W
authors.initials: BW
authors.lastname: Kramer
authors.affiliation: Department of Pediatrics, division of Neonatology, Máxima Medical Center, De Run 4600, 5504, MB, Veldhoven, The Netherlands; Department of Pediatrics, Maastricht University Medical Center, P. Debyelaan 25, 6229, HX, Maastricht, The Netherlands. Electronic address: p.andriessen@mmc.nl.
authors.forename: Peter
authors.initials: P
authors.lastname: Andriessen
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D041923:Adolescent Development; D016022:Case-Control Studies; D002657:Child Development; D020345:Enterocolitis, Necrotizing / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight / Q000254:growth & development* / Q000523:psychology; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development* / Q000523:psychology; D007360:Intelligence; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D008297:Male; D000071074:Neonatal Sepsis / Q000453:epidemiology* / Q000523:psychology; D010146:Pain / Q000453:epidemiology* / Q000523:psychology
keywords: Adolescents; Long-term follow-up; Newborn; POPS-19; Pain coping