Many Very Preterm Infants Experience Pain

THURSDAY, Jan. 30, 2025 (HealthDay News) — Many very preterm infants experience pain, according to a study published online Jan. 21 in Pain.

Hillary Graham, from the Karolinska Institutet in Stockholm, and colleagues explored the epidemiology of pain in liveborn infants <32 weeks of gestational age (GA) discharged between January 2020 and June 2024.

Of the 3,686 infants, 11.6 percent had a painful condition and 84.1 percent were exposed to at least one potentially painful procedure. The researchers found that 74.6 percent of the infants experienced pain, corresponding to 28,137 out of 185,008 (15.2 percent) days of neonatal care. Significantly lower proportions of infants experienced pain for every two-week increase in GA. The proportions with reported pain were approximately half the rate of painful procedures in infants <28 weeks of GA, while in infants born at 28 to 31 weeks, reported pain closely matched exposure to painful procedures. Overall, pain scales were used in 75 percent of the infants. Pharmacological pain treatment was administered to 81.7 percent of infants and was mainly topical or oral. The proportion of infants with pain treated intravenously was larger at higher GAs.

“There is a strong correlation between acute morbidity and being born very early. The earlier a baby is born, the more intensive care it needs. Intensive care involves procedures that can be painful, such as ventilator treatment, tube feeding, insertion of catheters into blood vessels and surgical procedures. It also requires various tests and investigations that may involve pain,” lead author Mikael Norman, M.D., Ph.D., also from the Karolinska Institutet, said in a press release. “Somewhat surprisingly, the smallest babies who were most exposed to pain had the lowest proportion of treatment with morphine. This may be a case of undertreatment.”

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