ArticleAnnals of neurology2011
Neonatal intensive care unit stress is associated with brain development in preterm infants.
Article in Annals of neurology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 209 papers, 8 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Supporting and Enhancing NICU Sensory Experiences to Optimize Developmental Outcomes in Preterm Infants
The Effect of Sleeping Environment on Sleep-Wake Organization in Preterm Infants
Who cites it
209 citing papers in PubMed, 8 syntheses or guidelines pooled it, 536 citations in OpenAlex.
- Sucrose or glucose compared to breast milk for pain control in preterm infants: a systematic review and meta-analysis.Journal of perinatology : official journal of the California Perinatal Association · 2025Pooled it
- Effect of Musical Stimulation on Placental Programming and Neurodevelopment Outcome of Preterm Infants: A Systematic Review.International journal of environmental research and public health · 2023Pooled it
- Sensory-based interventions in the NICU: systematic review of effects on preterm brain development.Pediatric research · 2022Pooled it
- Critical evaluation of contrasting evidence on whether male circumcision has adverse psychological effects: A systematic review.Journal of evidence-based medicine · 2022Pooled it
- Forty Years of Assessing Neurodevelopmental and Behavioral Effects of Prenatal Alcohol Exposure in Infants: What Have We Learned?Alcoholism, clinical and experimental research · 2019Pooled it
- Cognitive Outcomes of Children Born Extremely or Very Preterm Since the 1990s and Associated Risk Factors: A Meta-analysis and Meta-regression.JAMA pediatrics · 2018Pooled it
- Sensory modulation in preterm children: Theoretical perspective and systematic review.PloS one · 2017Pooled it
- Nurses' strategies to provide emotional and practical support to the mothers of preterm infants in the neonatal intensive care unit: A systematic review and meta-analysis.Women's health (London, England)Pooled it
- Neurodevelopmental outcome at 5 to 6 years of age of an early intervention program in preterm infants.Scientific reports · 2025Trial
- Effect of magnetic auricular acupuncture on pain during ophthalmic examination of the newborn: a multicenter, triple-blinded, randomized controlled study.BMC pediatrics · 2025Trial
- Decreased amygdala volume in adults after premature birth.Scientific reports · 2021Trial
- Behavioural and cognitive outcomes following an early stress-reduction intervention for very preterm and extremely preterm infants.Pediatric research · 2019Trial
- Sucrose vs. skin to skin care for preterm neonatal pain control-a randomized control trial.Journal of perinatology : official journal of the California Perinatal Association · 2018Trial
- Omega-3 and -6 fatty acid supplementation and sensory processing in toddlers with ASD symptomology born preterm: A randomized controlled trial.Early human development · 2017Trial
- Cerebral Lateralization is Protective in the Very Prematurely Born.Cerebral cortex (New York, N.Y. : 1991) · 2015Trial
- Heart rate variability during caregiving and sleep after massage therapy in preterm infants.Early human development · 2013Trial
- Massage improves growth quality by decreasing body fat deposition in male preterm infants.The Journal of pediatrics · 2013Trial
- Improving sleep duration in NICU graduates: a quality improvement initiative.BMJ open quality · 2026Article
- Regulation of Stress Physiology Across Social Contexts in Preterm-Born Preschoolers.Psychophysiology · 2026Article
- Review
149 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
10 authors at 2 institutions in 2 countries.
Funding
Abstract
objectiveAlthough many perinatal factors have been linked to adverse neurodevelopmental outcomes in very premature infants, much of the variation in outcome remains unexplained. The impact on brain development of 1 potential factor, exposure to stressors in the neonatal intensive care unit, has not yet been studied in a systematic, prospective manner.
methodsIn this prospective cohort study of infants born at <30 weeks gestation, nurses were trained in recording procedures and cares. These recordings were used to derive Neonatal Infant Stressor Scale scores, which were employed to measure exposure to stressors. Magnetic resonance imaging (brain metrics, diffusion, and functional magnetic resonance imaging) and neurobehavioral examinations at term equivalent postmenstrual age were used to assess cerebral structure and function. Simple and partial correlations corrected for confounders, including immaturity and severity of illness, were used to explore these relations.
resultsExposure to stressors was highly variable, both between infants and throughout a single infant's hospital course. Exposure to a greater number of stressors was associated with decreased frontal and parietal brain width, altered diffusion measures and functional connectivity in the temporal lobes, and abnormalities in motor behavior on neurobehavioral examination.
interpretationExposure to stressors in the Neonatal Intensive Care Unit is associated with regional alterations in brain structure and function. Further research into interventions that may decrease or mitigate exposure to stressors in the neonatal intensive care unit is warranted.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.