Procedural pain and brain development in preterm neonates

The improvement of technology in obstetrics and neonatology has resulted in an increase in the rate of preterm births and a decreased preterm mortality rate. In order to keep preterm infants alive, however, they are hospitalized for periods that can range from weeks to months, in special neonatal intensive care units (NICUs). As part of their medical care, they often undergo repetitive painful procedures at a time when their brain is developing very rapidly, with possible brain vulnerability to pain. Breakthrough research developments have generated research interest in investigating the effects of procedural pain on the brain and nervous system of preterm infants, including the possible development of neurological and neurodevelopmental disorders. Procedural pain appears to exert an adverse effect on the structural and metabolic differentiation of the brain in preterm infants, which is associated with their psychosocial and cognitive development, resulting in reduced cognitive and motor skills, and long-term problems of perception of logical reasoning, both visual and verbal, in their later life. It is necessary to implement strategies focused on reducing procedural pain from vital interventions in preterm infants.