title: Cumulative pain-related stress and developmental outcomes among low-risk preterm infants at one year corrected age.
abstract: Extensive exposure of preterm infants to pain-related stress (PRS) at a time of physiological immaturity and rapid brain development may contribute to altered neurodevelopment.
  
  
  
  To examine the relationship between early PRS and neurodevelopmental outcomes among low-risk very preterm infants at the age of one year corrected age (CA).
  
  
  
  Participants included 107 infants born <32weeks gestational age (GA) and monitored prospectively at 12.5months CA. Excluded were infants with severe neonatal morbidities associated with impaired neurodevelopment. PRS documentation was performed via the number of skin-breaking procedures (SBP) and by the use of the neonatal infant stressor scale (NISS). Adjustment was made for early neonatal morbidities.
  
  
  
  Developmental outcomes among the study infants were within the norm (mean 100±11.03). Infants who underwent invasive mechanical ventilation (IMV) (n=31) were exposed to significantly more PRS than non-IMV infants (n=76) (p<0.000). Developmental outcomes were similar in both groups (99.7±11.1 vs. 100.8±11 p=0.63). Among IMV infants, increased exposure to PRS was associated with lower developmental scores independent of GA, gender or other sociodemographic factors.
  
  
  
  Increased exposure to PRS among low-risk preterm infants who underwent IMV is associated with lower developmental scores at 12.5month CA.
authors.affiliation: Department of Neonatology, The Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Israel. Electronic address: Iris.Morag@sheba.health.gov.il.
authors.forename: Iris
authors.initials: I
authors.lastname: Morag
authors.affiliation: Sackler School of Medicine, Tel Aviv University, Israel.
authors.forename: Ifat
authors.initials: I
authors.lastname: Rotem
authors.affiliation: Sackler School of Medicine, Tel Aviv University, Israel. Electronic address: morf@mail.tau.ac.il.
authors.forename: Mor
authors.initials: M
authors.lastname: Frisch
authors.affiliation: Sackler School of Medicine, Tel Aviv University, Israel; Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Israel
authors.initials: I
authors.lastname: Hendler
authors.affiliation: Sackler School of Medicine, Tel Aviv University, Israel; Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer, Israel. Electronic address: michal.simchen@sheba.health.gov.il.
authors.forename: Michal J
authors.initials: MJ
authors.lastname: Simchen
authors.affiliation: Department of Neonatology, The Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Israel.
authors.forename: Leah
authors.initials: L
authors.lastname: Leibovitz
authors.affiliation: Department of Neonatology, The Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Israel. Electronic address: ayala.maayan@sheba.health.gov.il.
authors.forename: Ayala
authors.initials: A
authors.lastname: Maayan-Metzger
authors.affiliation: Department of Neonatology, The Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Israel.
authors.forename: Tzipora
authors.initials: T
authors.lastname: Strauss
mesh_terms: D000328:Adult; D002658:Developmental Disabilities / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D008297:Male; D010146:Pain / Q000453:epidemiology*; D011247:Pregnancy; D059285:Pregnancy, Twin / Q000706:statistics & numerical data; D012121:Respiration, Artificial / Q000009:adverse effects / Q000706:statistics & numerical data; D013315:Stress, Psychological / Q000453:epidemiology*