Abstract
An increased awareness on neonatal pain-associated complications has led to the development of pain scales adequate to assess the level of pain experienced by newborns such as the ABC score. A commonly used analgesic procedure is to administer a 33% oral dextrose solution to newborns prior to the painful intervention. Although this procedure is very successful, not in all subjects it reaches complete efficacy. A possible explanation for the different response to the treatment could be genetic variability. We have investigated the genetic variability of the OPRM1 gene in 1077 newborns in relation to non-pharmacologic pain relief treatment. We observed that the procedure was successful in 966 individuals and there was no association between the genotypes and the analgesic efficacy when comparing individuals that had an ABC score = 0 and ABC score >0. However, considering only the individuals with ABC score>0, we found that the homozygous carriers of the G allele of the missense variant SNP rs1799971 (A118G) showed an interesting association with higher ABC score. We also observed that individuals fed with formula milk were more likely to not respond to the analgesic treatment compared to those that had been breastfed.
Highlights
An increased awareness on neonatal pain-associated complications has led to the development of pain scales adequate to assess the level of pain experienced by newborns such as the ABC score
The MOR-1 receptor is encoded by the OPRM1 gene that is highly polymorphic and many studies performed in adults have suggested an association between the genetic variability in the OPRM1 gene, and the response to pain relief treatment in adults[18,19,20,21,22,23,24,25]
To the best of our knowledge, there are no studies linking the effect of the dextrose/glucose treatment with the genetic variability of the gene. With these premises we have investigated for the first time the genetic variability of the OPRM1 gene in 1077 newborns collected at University Hospital of Santa Chiara, in relation to non-pharmacologic pain relief treatment
Summary
An increased awareness on neonatal pain-associated complications has led to the development of pain scales adequate to assess the level of pain experienced by newborns such as the ABC score. A commonly used approach is to administer an oral dextrose solution (20 to 33% concentration) to newborns prior to the painful intervention[11] This procedure is very successful, not in all subjects it reaches analgesic efficacy. The MOR-1 receptor is encoded by the OPRM1 gene that is highly polymorphic and many studies performed in adults have suggested an association between the genetic variability in the OPRM1 gene, and the response to pain relief treatment in adults[18,19,20,21,22,23,24,25] Despite all these evidences, to the best of our knowledge, there are no studies linking the effect of the dextrose/glucose treatment with the genetic variability of the gene. With these premises we have investigated for the first time the genetic variability of the OPRM1 gene in 1077 newborns collected at University Hospital of Santa Chiara, in relation to non-pharmacologic pain relief treatment
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