ArticlePain2013
Parent behaviors moderate the relationship between neonatal pain and internalizing behaviors at 18 months corrected age in children born very prematurely.
Article in Pain, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
51 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- [Evidence-based guideline for neonatal pain management in China (2023)].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2023Guideline
- NICU infant health severity and family outcomes: a systematic review of assessments and findings in psychosocial research.Journal of perinatology : official journal of the California Perinatal Association · 2019Pooled it
- Parenting style impacts cognitive and behavioural outcomes of former preterm infants: A systematic review.Child: care, health and development · 2018Pooled it
- Early maternal care restores LINE-1 methylation and enhances neurodevelopment in preterm infants.BMC medicine · 2021Trial
- Association Between Neonatal Pain Exposure and Neurodevelopmental Outcomes in Very Preterm Infants During the COVID-19 Pandemic: A Retrospective Observational Study.Children (Basel, Switzerland) · 2026Article
- Long-term impact of necrotizing enterocolitis on somatosensory function in preterm born children.Pediatric research · 2026Article
- Barriers and facilitators to implementing parent-led infant pain care in rural settings: A qualitative descriptive study using the Theoretical Domains Framework and COM-B Model.Canadian journal of pain = Revue canadienne de la douleur · 2026Article
- A scoping review of responsive caregiving in diverse populations and its association with child development.Early human development · 2026Article
- Social Determinants of Health and Early Brain Development.Pediatric clinics of North America · 2025Review
- A Cross-Lagged Panel Analysis of Cortisol Levels and Internalizing Behaviors in Children Born Very Preterm Across Early Childhood: Associations Differ for Boys and Girls at Age 1.5 Years.Developmental psychobiology · 2025Article
- A Narrative Review of Neurodevelopmental, Psychiatric, and Behavioral Consequences of Preterm Birth.Cureus · 2025Review
- Neonatal Sucrose and Internalizing Behaviors at 18 Months in Children Born Very Preterm.JAMA network open · 2025Article
- Neonatal amygdala volumes, procedural pain and the association with social-emotional development in children born very preterm.Brain structure & function · 2024Article
- Neonatal paw pricking alters adolescent behavior in a sex-dependent manner and sucrose partially remediates the effects.Physiology & behavior · 2024Article
- Cortisol levels are related to neonatal pain exposure in children born very preterm at age 18 months in two independent cohorts.Paediatric & neonatal pain · 2023Article
- Current pain management practices for preterm infants with necrotizing enterocolitis: a European survey.Pediatric research · 2023Article
- Emotional Regulation Interventions on Developmental Course for Preterm Children: A Systematic Review of Randomized Control Trials.Children (Basel, Switzerland) · 2023Review
- Home Immunization with Palivizumab-A Randomized Pilot Study Describing Safety Aspects and Parents' Preferences.Children (Basel, Switzerland) · 2023Article
- Skin-to-skin contact-An effective intervention on pain and stress reduction in preterm infants.Frontiers in pediatrics · 2023Article
- Early neurodevelopmental follow-up in the NICHD neonatal research network: Advancing neonatal care and outcomes, opportunities for the future.Seminars in perinatology · 2022Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
Children born very preterm (≤ 32 weeks gestation) exhibit greater internalizing (anxious/depressed) behaviors compared to term-born peers as early as 2 years corrected age (CA); however, the role of early stress in the etiology of internalizing problems in preterm children remains unknown. Therefore, we examined the relationship between neonatal pain and internalizing behavior at 18 months CA in children born very preterm and examined whether parent behavior and stress moderated this relationship. Participants were 145 children (96 very preterm, 49 full term) assessed at 18 months CA. Neonatal data were obtained from medical and nursing chart review. Neonatal pain was defined as the number of skin-breaking procedures. Cognitive ability was measured with the Bayley Scales of Infant Development II. Parents completed the Parenting Stress Index III, Child Behavior Checklist 1.5-5, and participated in a videotaped play session with their child, which was coded using the Emotional Availability Scale IV. Very preterm children displayed greater Internalizing behaviors compared to full-term control children (P=.02). Parent Sensitivity and Nonhostility moderated the relationship between neonatal pain and Internalizing behavior (all P<.05); higher parent education (P<.03), lower Parenting Stress (P=.001), and fewer children in the home (P<.01) were associated with lower Internalizing behavior in very preterm children, after adjusting for neonatal medical confounders, gender, and child cognitive ability (all P>.05). Parent Emotional Availability and stress were not associated with Internalizing behaviors in full-term control children. Positive parent interaction and lower stress appears to ameliorate negative effects of neonatal pain on stress-sensitive behaviors in this vulnerable population.
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Registered trials
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