Observational studyPediatric research2021
The newborn infant parasympathetic evaluation index for acute procedural pain assessment in preterm infants.
Observational study in Pediatric research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02885051 (Comparative Analysis of a Behavioral Level, Skin Conductance and Heart Rate Variability in Assessing the Pain in Preterm Newborn), which is not on this map. Cited by 12 papers, 1 of them a synthesis 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.
Comparative Analysis of a Behavioral Level, Skin Conductance and Heart Rate Variability in Assessing the Pain in Preterm Newborn
Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- Clinical rating scales for assessing pain in newborn infants.The Cochrane database of systematic reviews · 2025Pooled it
- Pain Assessment During Less Invasive Surfactant Administration Using Skin Conductance: A Prospective Cohort Study.Pediatric research · 2026Observational
- Application of Intelligent Neonatal Pain Assessment Tools Based on Multimodal Data Fusion: A Systematic Review.Journal of pain research · 2026Review
- Baseline NIPEEuropean journal of pediatrics · 2025Observational
- Objective Detection of Newborn Infant Acute Procedural Pain Using EEG and Machine Learning Algorithms.Paediatric & neonatal pain · 2025Article
- The Newborn Infant Parasympathetic Evaluation Index for Assessment of Procedural Pain and Discomfort in Mechanically Ventilated Pediatric Intensive Care Patients: A Prospective, Exploratory, Observational Study.Paediatric anaesthesia · 2025Observational
- Pain and heart rate variability in neonates receiving dexmedetomidine.Journal of perinatology : official journal of the California Perinatal Association · 2024Article
- Speed of heart rate changes during postural provocations in children and adolescents.Scientific reports · 2024Article
- Biomarkers for assessing pain and pain relief in the neonatal intensive care unit.Frontiers in pain research (Lausanne, Switzerland) · 2024Review
- Usefulness of two types of pain monitors in newborns treated in NICU, in the opinion of experts: Results of the survey.Journal of mother and child · 2022Article
- Autonomic measures identify stress, pain, and instability associated with retinopathy of prematurity ophthalmologic examinations.Frontiers in pain research (Lausanne, Switzerland) · 2022Article
- Procedural Pain Assessment in Infants Without Analgosedation: Comparison of Newborn Infant Parasympathetic Evaluation and Skin Conductance Activity - A Pilot Study.Frontiers in pediatrics · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundAccurate assessments of pain in hospitalized preterm infants present a major challenge in improving the short- and long-term consequences associated with painful experiences. We evaluated the ability of the newborn infant parasympathetic evaluation (NIPE) index to detect acute procedural pain in preterm infants.
methodsDifferent painful and stressful interventions were prospectively observed in preterm infants born at 25 + 0 to 35 + 6 weeks gestation. Pain responses were measured using the composite Premature Infant Pain Profile Revised (PIPP-R) scale, the NIPE index, and skin conductance responses (SCR). Outcome measures were correlations between the NIPE index, the PIPP-R score, and the SCR. Sensitivity/specificity analyses tested the accuracy of the NIPE index and SCR.
resultsTwo hundred and fifty-four procedures were recorded in 90 preterm infants. No significant correlation was found between PIPP-R and the NIPE index. PIPP-R and SCR were positively correlated (r = 0.27, P < 0.001), with stronger correlations for painful procedures (r = 0.68, P < 0.001) and especially for skin-breaking procedures (r = 0.82, P < 0.001). The NIPE index and SCR had high sensitivity and high negative predictive values to predict PIPP-R > 10, especially for skin-breaking painful procedures.
conclusionsWe found no significant correlation between the NIPE index and PIPP-R during routine painful or stressful procedures in preterm infants. IMPACT: Exposure to repetitive pain can lead to neurodevelopmental sequelae. Behavior-based pain scales have limited clinical utility, especially for preterm infants. New devices for monitoring physiological responses to pain have not been validated sufficiently in preterm infants. This study found that the NIPE index was not significantly correlated to the validated PIPP-R scale during acute procedural pain. Secondary analysis of this study showed that NIPE index and SCRs may help to exclude severe pain in preterm infants. In clinical practice, measurements of physiological parameters should be combined with behavior-based scales for multidimensional pain assessments.
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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.