关键词: 早产儿, 操作性疼痛, 认知, 退缩行为, 抑郁

Abstract: Objective In order to analyse the long-term effects of neonatal pain,and to observe the behavioral development of toddlers with repetitive procedaral pain experience in NICU during preterm infancy,as well as the relation to parenting environment,and to clarify long-term effects of neonatal pain on physical health. Methods A total of 25 preterm neonates admitted to NICU in Children's Hospital of Nanjing Medical University after birth were selected as preterm group (n=25).Thirty-eight term neonates healthly born at the same period and without hospitalization experience were selected as full-term group.When follow-up at 2 years postconception age (PCA),the parents filled in the questionnaire including general characteristics of children and parents,Parenting Stress Index-short form (PSI) and Child Behavior Check List (CBCL);At the same time,the toddlers underwent physical examination and Gesell Development Schedule (GDS). Results The development quotients (DQ) of GDS significantly decreased in preterm group compared to full-term group at 2 years PCA (P<0.05).Poor cognitive development of preterm group was related to the increased NICU skin-breaking procedures (P<0.05) and their mother's PSI score (P<0.05),as well as low education of mother (P<0.05).The internalizing behavior score manifested by withdrawn behaviors and depression significantly increased in preterm group,compared with full-term group at 2 years PCA (P<0.05).The higher internalizing behavior in Preterm Group was positively correlated with high PSI of their mother (P<0.05). Conclusions Compared with full-term counterparts,the preterm born toddlers have poorer cognitive development and increased internalizing behaviors at 2 years PCA.The poorer cognitive outcome in preterm born toddlers are related to the higher number of skin-breaking procedures experienced during NICU hospitalization.What's more,more parenting stress from mother will worsen the Results .

Key words: preterm infants, procedural pain, cognition, withdrawn behaviors, depression