Background and Aim: Hospitalized neonates, particularly if preterm, are exposed to prolonged pain. At present the only validated scale to assess prolonged pain in preterms is the EDIN (Echelle Douleur Inconfort Nouveau-Né) scale. Gestational age (GA) has been shown to influence the response of infants to acute pain but its potential effect in the setting of prolonged pain has not been investigated. The aim of the present study was to evaluate whether neonatal maturity as expressed by GA and/or postnatal age (PNA) influences the expression of prolonged pain.
Methods: In a one year period, 84 neonates (GA 25-41 weeks) were referred to our NICU and evaluated by the EDIN scale 2-3 times a day, obtaining 1571 scores. The EDIN scores were categorized as indicative (> 6) or not indicative (<= 6) of pain. GA and PNA were included in a logistic regression analysis with some painful situations and analgesic treatment to identify the impact on the EDIN scores. The SPSS statistical package was used (V 13.0) for the analysis.
Results: Logistic regression analysis showed that EDIN scores were positively associated with GA (OR, 95% CI: 1.166, 1.123-1.211). PNA, sepsis and presence of respiratory support also influenced EDIN score.
Conclusions: GA influences expression of prolonged pain. Content validity of the EDIN scale could be improved by adding categories for GA and attributing higher basal scores to less mature newborns.
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