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

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.