ArticleEarly human development2017
The impact of cumulative pain/stress on neurobehavioral development of preterm infants in the NICU.
Article in Early human development, 2017. 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 86 papers, 5 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.
The Effect of Modified Pacifier on Pain, Physiological Variables, and Stress Level in Children Connected to Mechanical Ventilators During Vascular Opening
The Effect of Modified Teat on Pain, Physiological Variables, and Stress Level During Heel Blood Collection in Mechanically Ventilated Term Newborns
Who cites it
86 citing papers in PubMed, 5 syntheses or guidelines pooled it, 246 citations in OpenAlex.
- Midazolam for sedation of infants in the neonatal intensive care unit.The Cochrane database of systematic reviews · 2025Pooled it
- Critical review of the evidence for Vojta Therapy: a systematic review and meta-analysis.Frontiers in neurology · 2024Pooled it
- [Evidence-based guideline for neonatal pain management in China (2023)].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2023Guideline
- Effects of Kangaroo Mother Care in the NICU on the Physiological Stress Parameters of Premature Infants: A Meta-Analysis of RCTs.International journal of environmental research and public health · 2022Pooled it
- Associations of Mitochondrial Function, Stress, and Neurodevelopmental Outcomes in Early Life: A Systematic Review.Developmental neuroscience · 2022Pooled it
- The Effect of Auricular Massage on Naso-Oral Suctioning Procedural Pain in Premature Neonates: A Randomized Controlled Crossover Study.TheScientificWorldJournal · 2025Trial
- Trial
- Impact of diaper change frequency on preterm infants' vital sign stability and skin health: A RCT.Early human development · 2022Trial
- Maternal Anxiety, Infant Stress, and the Role of Live-Performed Music Therapy during NICU Stay in The Netherlands.International journal of environmental research and public health · 2021Trial
- [Clinical effect of white noise combined with glucose in reducing the pain of retinopathy screening in preterm infants].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2019Trial
- Trial
- Reconsidering transcutaneous bilirubinometry for management of neonatal hyperbilirubinemia: is it time for change?Journal of perinatology : official journal of the California Perinatal Association · 2026Review
- Clinical Judgement of Comfort in Preterm Infants by Neonatal Intensive Care Unit Nurses Accurately Reflects Neonatal Stress Exposure.American journal of perinatology · 2026Observational
- 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
- Study Protocol for a Randomized Controlled Trial of Multisensory Early Oral Administration of Human Milk (M-MILK) for Very Preterm Infants: Enhancing Stress Regulation, Neurodevelopment, and Oral Feeding Skills.Biological research for nursing · 2026Article
- Parental experience and professional training shape the perception of comfort and discomfort in preterm and term newborns.Scientific reports · 2026Article
- Association between exposure to stress and experienced discomfort in preterm infants.Pediatric research · 2026Article
- Greater Increase in Hippocampal Activity During the Early Postnatal Period After Preterm Birth Is Associated With Better Cognitive and Motor Outcomes at 18 Months.Developmental neurobiology · 2026Article
- Predicting serum phosphate levels in very preterm infants using machine learning.Frontiers in pediatrics · 2026Article
- Early-life painful and stressful exposures and neurodevelopment in preterm infants.Frontiers in pediatrics · 2026Article
26 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
9 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundVulnerable preterm infants experience repeated and prolonged pain/stress stimulation during a critical period in their development while in the neonatal intensive care unit (NICU). The contribution of cumulative pain/stressors to altered neurodevelopment remains unclear. The study purpose was to investigate the impact of early life painful/stressful experiences on neurobehavioral outcomes of preterm infants in the NICU.
methodsA prospective exploratory study was conducted with fifty preterm infants (28 0/7-32 6/7weeks gestational age) recruited at birth and followed for four weeks. Cumulative pain/stressors (NICU Infant Stressor Scale) were measured daily and neurodevelopmental outcomes (NICU Network Neurobehavioral Scale) were examined at 36-37weeks post-menstrual age. Data analyses were conducted on the distribution of pain/stressors experienced over time and the linkages among pain/stressors and neurobehavioral outcomes.
resultsPreterm infants experienced a high degree of pain/stressors in the NICU, both in numbers of daily acute events (22.97±2.30 procedures) and cumulative times of chronic/stressful exposure (42.59±15.02h). Both acute and chronic pain/stress experienced during early life significantly contributed to the neurobehavioral outcomes, particularly in stress/abstinence (p<0.05) and habituation responses (p<0.01), meanwhile, direct breastfeeding and skin-to-skin holding were also significantly associated with habituation (p<0.01-0.05).
conclusionUnderstanding mechanisms by which early life experience alters neurodevelopment will assist clinicians in developing targeted neuroprotective strategies and individualized interventions to improve infant developmental outcomes.
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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.