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Enfance

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Enfance (2013), 2013:15-31 (2013), 2013:15-31 NecPlus
Copyright © Nec Plus / Association scientifique Henri Wallon 2013
doi:10.4074/S0013754513001043

Research Article

Long term effects of pain-related stress on neurodevelopment and pain perception of infants born very prematurely


Ruth E. Grunau c1

Article author query
grunau re [Google Scholar]

SUMMARY

While survival rates of infants born very prematurely increased greatly during the past three decades, neurodevelopmental outcomes have not improved. Problems in behavior, executive functions, visual perceptual abilities, learning, academic, and motor problems remain highly prevalent. Currently there is little understanding of the etiology and mechanisms that underlie these problems in this population, that are prevalent in former preterm children who escape major neurosensory or motor impairment. Given the extensive animal literature that has established causal foundations for the impact of early environmental stress on the developing organism, it is possible that exposure to prolonged and repetitive pain-related stress in infants born very preterm may potentially have long term effects contributing to altered neurobehavioral development in vulnerable infants. The focus of this review is evidence for long-term effects of early pain-related stress on brain development, neurodevelopment, programming of stress systems and later pain perception in infants born preterm.

RÉSUMÉ

L’augmentation du taux de survie d’enfants nés extrêmement prématurés avant 28 semaines d’âge gestationnel, notée depuis une trentaine d’années, ne s’est pas accompagnée d’une amélioration aussi franche de leur devenir neurodéveloppemental. Les suivis montrent en effet une prévalence élevée de troubles concernant le comportement, les habiletés perceptivo motrices, les fonctions exécutives, les apprentissages scolaires. À ce jour toutefois, la compréhension des causes et des mécanismes de formation de ces troubles du développement reste encore d’autant plus lacunaire qu’ils concernent les enfants prématurés avec séquelles lésionnelles mais aussi le devenir des enfants prématurés indemnes de déficits lésionnels neurosensoriels ou neuromoteurs.

Key-words:Pain; Stress; Preterm; Development; Behavior; Brain; Cortisol

Mots clés:douleur ; stress ; prÉmaturitÉ ; dÉveloppement ; comportement ; cerveau ; cortisol

Correspondence:

c1 Address for correspondence: Developmental Neurosciences & Child Health, Room F605B, 4480 Oak Street, Vancouver, B.C. V6H 3V4, Canada; Email : rgrunau@cw.bc.ca


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