Abstract

Preterm infants undergo early separation from parents and are exposed to frequent painful clinical procedures, with resultant short- and long-term effects on their neurodevelopment. We aimed to establish whether the mother’s voice could provide an effective and safe analgesia for preterm infants and whether endogenous oxytocin (OXT) could be linked to pain modulation. Twenty preterm infants were exposed to three conditions—mother’s live voice (speaking or singing) and standard care—in random order during a painful procedure. OXT levels (pg/mL) in saliva and plasma cortisol levels were quantified, and the Premature Infant Pain Profile (PIPP) was blindly coded by trained psychologists. During the mother’s live voice, PIPP scores significantly decreased, with a concomitant increase in OXT levels over baseline. The effect on pain perception was marginally significant for singing. No effects on cortisol levels were found. The mother’s live voice modulated preterm infants’ pain indicators. Endogenous OXT released during vocal contact is a promising protective mechanism during early painful interventions in at-risk populations.

Highlights

  • Preterm infants undergo early separation from parents and are exposed to frequent painful clinical procedures, with resultant short- and long-term effects on their neurodevelopment

  • Several painful clinical procedures occur for preterm infants in the first days after birth in Neonatal Intensive Care Unit (NICU) in the context of partial or total separation from their parents

  • We aimed to evaluate the effects of reducing separation between the mother and her prematurely-born offspring on pain perception and on OXT release during a routine painful clinical procedure in the NICU

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Summary

Introduction

Preterm infants undergo early separation from parents and are exposed to frequent painful clinical procedures, with resultant short- and long-term effects on their neurodevelopment. Very preterm infants experience early and prolonged separation from their parents during hospitalisation in the NICU, and this separation has profound impacts on their stress ­levels[8], as well as on their autonomic, neuroendocrine and immune ­systems[10]. This separation can alter preterm infants’ long-term neurodevelopment, with important effects on emotional and attachment processes for both the infants and their ­parents[11,12,13,14,15]. Long-term dysfunctions in the neuroendocrine system and down-regulation

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