Study Uncovers Shortcomings in Pain Management for Preterm Babies in Intensive Care
A large proportion of babies born very early need intensive care, which can be painful. But the healthcare system fails to provide pain relief to the full extent. This is shown by the largest survey to date of pain in neonatal care, published in the journal Pain.
Every day for 4.5 years, neonatal care staff have recorded the occurrence of pain, the causes of pain, and how pain is assessed and treated in premature babies in Sweden. The study covers 3,686 babies born between 22 and 31 weeks of gestation from 2020 to 2024. The total observation time was just over 185,000 days of care.
The researchers found that babies born extremely early, in weeks 22 to 23, had the highest proportion of painful medical conditions and almost daily painful intensive care procedures throughout the first month after birth. However, this is not surprising.
90 percent of the most extremely preterm infants had to undergo painful procedures. Despite this, healthcare professionals reported that only 45 percent of babies experienced pain - which may be because pain was largely prevented or treated. However, a check of the drugs administered suggests other explanations may exist.
One limitation is that the study could not determine the duration or severity of pain for each day reported. However, it is a problem and a challenge that healthcare professionals are not always able to determine whether children are in pain.
It is very important to improve pain management for premature babies, as we now know that their development is negatively affected by the strong signals in the brain that pain causes.
“The vision for all neonatal care is to be pain-free. The results of this survey will be of great importance for improving neonatal care and for future research in the field,” concludes Mikael Norman, professor of paediatrics at the Department of Clinical Science, Intervention and Technology, Karolinska Institutet, and lead researcher of the study.
Reference: Graham, Hillarya; Razaz, Nedaa; Håkansson, Stellanb; Blomqvist, Ylva Thernströmc; Johansson, Karia,d; Persson, Martinae; Nyholm, Annikab; Norman, Mikaelf,g,*. Pain in very preterm infants—prevalence, causes, assessment, and treatment. A nationwide cohort study. PAIN ():10.1097/j.pain.0000000000003528, January 21, 2025. | DOI: 10.1097/j.pain.0000000000003528
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