ArticleEuropean journal of pain (London, England)2014
Internalizing behaviours in school-age children born very preterm are predicted by neonatal pain and morphine exposure.
Article in European journal of pain (London, England), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 62 papers, 4 of them syntheses that pooled it.
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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.
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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.
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Who cites it
62 citing papers in PubMed, 4 syntheses or guidelines pooled it, 150 citations in OpenAlex.
- Acupuncture for procedural pain in newborn infants.The Cochrane database of systematic reviews · 2025Pooled it
- Non-pharmacological management of infant and young child procedural pain.The Cochrane database of systematic reviews · 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
- Association of Preterm Birth and Low Birth Weight With Romantic Partnership, Sexual Intercourse, and Parenthood in Adulthood: A Systematic Review and Meta-analysis.JAMA network open · 2019Pooled it
- 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
- 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
- Neonatal unit (NU) Infant Medical Trauma and the lifelong implications for children and their families.Frontiers in psychology · 2026Review
- Sweet relief or lasting impacts? Review of neonatal pain and sucrose in developing rodents.Pain reports · 2025Article
- A cross-sectional analysis of brain structure, pain behaviors, and mental health in persons with surgically confirmed endometriosis.Communications biology · 2025Article
- Origins and Previous Experiences from a Gender Perspective on the Perception of Pain in Nursing Students: Study Protocol.Healthcare (Basel, Switzerland) · 2025Article
- Promoting Equity in Parent Presence and Participation in Neonatal Intensive Care: Protocol for a Prospective Cohort Study.JMIR research protocols · 2025Article
- 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
- Neonatal Sucrose and Internalizing Behaviors at 18 Months in Children Born Very Preterm.JAMA network open · 2025Article
- Dexmedetomidine for analgesia and sedation for procedural pain or discomfort in newborn infants.The Cochrane database of systematic reviews · 2025Article
- Efficacy of expressed breast milk, facilitated tucking, and their combination for pain management during heel stick in preterm neonates: a randomized controlled trial.Frontiers in pediatrics · 2025Article
- Brain health in preterm infants: importance of early-life pain and analgesia exposure.Pediatric research · 2024Review
- Dexmedetomidine as a Short-Use Analgesia for the Immature Nervous System.International journal of molecular sciences · 2024Article
- Association between opioid use during mechanical ventilation in preterm infants and evidence of brain injury: a propensity score-matched cohort study.EClinicalMedicine · 2023Article
- Neurodevelopmental, Mental Health, and Parenting Issues in Preterm Infants.Children (Basel, Switzerland) · 2023Article
- 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
2 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundGreater neonatal pain is associated with higher internalizing behaviours in very preterm infants at 18 months corrected age, but it is unknown whether this relationship persists to school age. Moreover, it is unclear whether morphine ameliorates or exacerbates the potential influence of neonatal pain/stress on internalizing behaviours. We examined whether neonatal pain-related stress is associated with internalizing behaviours at age 7 years in children born very preterm, and whether morphine affects this relationship.
methodsOne hundred one children born very preterm (≤32 weeks gestation) were seen at mean age 7.7 years. A parent completed the Parenting Stress Index and Child Behavior Checklist questionnaires. Neonatal pain-related stress (the number of skin-breaking procedures adjusted for clinical factors associated with prematurity) was examined in relation to internalizing behaviour, separately in subjects mechanically ventilated and exposed to both pain and morphine (n = 57) and those never mechanically ventilated, exposed to pain but not morphine (n = 44).
resultsIn the non-ventilated group, higher skin-breaking procedures (p = 0.037) and parenting stress (p = 0.004) were related to greater internalizing behaviours. In the ventilated group, greater morphine exposure (p = 0.004) was associated with higher child internalizing scores.
conclusionsIn very preterm children who undergo mechanical ventilation, judicious use of morphine is important, since morphine may mitigate the negative effects of neonatal pain on nociception but adversely affect internalizing behaviours at school age. Management of procedural pain needs to be addressed in very preterm infants in the neonatal intensive care unit, to prevent long-term effects on child behaviour.
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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.