ArticlePloS one2013
Neonatal pain-related stress predicts cortical thickness at age 7 years in children born very preterm.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 118 papers, 8 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
118 citing papers in PubMed, 8 syntheses or guidelines pooled it, 280 citations in OpenAlex.
- Opioid equipotency conversions for hospitalized infants: a systematic review.Journal of perinatology : official journal of the California Perinatal Association · 2024Pooled it
- Non-pharmacological pain relief interventions in preterm neonates undergoing screening for retinopathy of prematurity: a systematic review.BMJ open ophthalmology · 2023Pooled it
- [Evidence-based guideline for neonatal pain management in China (2023)].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2023Guideline
- Perinatal stress and methylation of theEpigenetics · 2022Pooled it
- Pooled it
- Continuous glucose monitoring for the prevention of morbidity and mortality in preterm infants.The Cochrane database of systematic reviews · 2021Pooled it
- Continuous glucose monitoring for the prevention of morbidity and mortality in preterm infants.The Cochrane database of systematic reviews · 2020Pooled it
- Development of Cardiovascular Indices of Acute Pain Responding in Infants: A Systematic Review.Pain research & management · 2016Pooled it
- 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
- Neonatal pain response to automatic lancet versus needle heel-prick blood sampling: A prospective randomized controlled clinical trial.Pediatrics international : official journal of the Japan Pediatric Society · 2020Trial
- Sweeter recovery, less intravenous fluids: a NICU quality improvement initiative for managing neonatal hypoglycemia.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- 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
- Noninvasive measurement of glucose and lactate in thermoregulatory sweat in neonates and adults.Science advances · 2026Article
- Early-Life Clinical Factors Shape Cerebellar Structure in Preterm-Born Children.Annals of the Child Neurology Society · 2026Article
- Nonpharmacological Pain Management for Premature Neonates in Neonatal Intensive Care Units: A Meta-Analysis.Health science reports · 2026Review
- Long-term impact of necrotizing enterocolitis on somatosensory function in preterm born children.Pediatric research · 2026Article
- Sweet relief or lasting impacts? Review of neonatal pain and sucrose in developing rodents.Pain reports · 2025Article
- Prematurity and Epigenetic Regulation ofBiomedicines · 2025Article
- Sedation and Analgesia for Intubation, LISA, and INSURE Procedures in Israeli NICUs: Caregivers' Practices and Perspectives.Journal of clinical medicine · 2025Article
58 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundAltered brain development is evident in children born very preterm (24-32 weeks gestational age), including reduction in gray and white matter volumes, and thinner cortex, from infancy to adolescence compared to term-born peers. However, many questions remain regarding the etiology. Infants born very preterm are exposed to repeated procedural pain-related stress during a period of very rapid brain development. In this vulnerable population, we have previously found that neonatal pain-related stress is associated with atypical brain development from birth to term-equivalent age. Our present aim was to evaluate whether neonatal pain-related stress (adjusted for clinical confounders of prematurity) is associated with altered cortical thickness in very preterm children at school age.
methods42 right-handed children born very preterm (24-32 weeks gestational age) followed longitudinally from birth underwent 3-D T1 MRI neuroimaging at mean age 7.9 yrs. Children with severe brain injury and major motor/sensory/cognitive impairment were excluded. Regional cortical thickness was calculated using custom developed software utilizing FreeSurfer segmentation data. The association between neonatal pain-related stress (defined as the number of skin-breaking procedures) accounting for clinical confounders (gestational age, illness severity, infection, mechanical ventilation, surgeries, and morphine exposure), was examined in relation to cortical thickness using constrained principal component analysis followed by generalized linear modeling.
resultsAfter correcting for multiple comparisons and adjusting for neonatal clinical factors, greater neonatal pain-related stress was associated with significantly thinner cortex in 21/66 cerebral regions (p-values ranged from 0.00001 to 0.014), predominately in the frontal and parietal lobes.
conclusionsIn very preterm children without major sensory, motor or cognitive impairments, neonatal pain-related stress appears to be associated with thinner cortex in multiple regions at school age, independent of other neonatal risk factors.
Indexed as
Identifiers
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.