Differences in Pain Expression between Male and Female Newborn Infants

Guinsburg, Ruth; Fernánda, María; Almeida, Bianca; Perez, Clovis A.; Balda, Rita de Cássia Xavier; Berenguel, Rosevânia C.; Tonelotto, Jaqueline; Kopelman, Benjamin Israel

doi:10.1203/00006450-199904020-01188

Cited by 41 publications

(53 citation statements)

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“…Since full extension is thought to cause distress to the neonate, accuracy may be influenced by reluctance of the measurer to cause discomfort, even by exerting gentle force. This study confirms that crownÁheel measurement technique causes distress to neonates, with NFCS scores similar to those registered during the heel-stick procedure for blood sampling [10]. Measurements with one lower limb fully extended result in significantly less discomfort than with both lower limbs, as conventionally recommended [5,6].…”

Section: Discussionsupporting

confidence: 80%

“…In concordance with Grunau et al [12] and Stevens et al [20], we found no differences in NFCS scores between sexes. Guinsburg et al [10] found that female newborn infants express more facial features of pain than their male counterparts during capillary puncture and 1 min afterwards. The different NFCS scores between sexes may rely on different invasive and non-invasive procedures assessed in the different studies.…”

Section: Discussionmentioning

confidence: 99%

“…A systematic sample of healthy full-term neonates (37 to 41 wk), consecutively born between 21.00 and 03.00, at Hospital Dona Estefânia Maternity, Lisbon, Portugal, was included after parental consent. Neonates born by breech presentation, with a history of oligohydramnios, any clinical or laboratorial sign of disease, or maternal use of systemic opioids during pregnancy, labour or delivery were excluded from the study [9,10].…”

Section: Methodsmentioning

confidence: 99%

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Reducing discomfort while measuring crown–heel length in neonates

Pereira‐da‐Silva¹,

Bergmans²,

Kerkhoven³

et al. 2006

Acta Paediatrica

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Aim: To assess the degree of discomfort caused by length measurement in neonates, performed with one or both lower limbs extended, on the first and second day after birth, with either one or both lower limbs extended. Methods: Healthy full-term neonates were systematically sampled during the months of February and March 2004. Crown Áheel length was measured, using a 1-mm precision neonatometer, at approximately 8 h and 32 h after birth, with one and both lower limbs extended. The Neonatal Facial Coding System was used to assess discomfort during measurements. Data were analysed by parametric and non-parametric tests as appropriate. Results: Whatever the measurement technique, discomfort scores are significantly higher during the length measurement than at baseline. Whenever length measurements are performed, discomfort scores are significantly higher when extending both lower limbs rather than one lower limb (p B/0.006). The measured length is greater with one lower limb extended; however, the difference decreases over time, being 0.19 cm (95% CI 0.1 Á0.3; p B/0.001) at approximately 32 h of age. No significant differences in length were found between measurements at approximately 8 or 32 h, regardless of the technique used. The best correlation between length measurements with one or both lower limbs extended was observed at approximately 32 h after birth (r 0/0.98). Conclusion:Measuring crown Áheel length is a distressful procedure for the neonate. Measurements with one lower limb extended result in less discomfort than when both lower limbs are extended, without decreasing the accuracy.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Reducing discomfort while measuring crown–heel length in neonates

Pereira‐da‐Silva¹,

Bergmans²,

Kerkhoven³

et al. 2006

Acta Paediatrica

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show abstract

“…An early female advantage in fine motor behavior is also suggested by more accurate imitation of finger movements in neonatal girls than in boys (Nagy, Kompagne, Orvos, & Pal, 2007). Finally, consistent with known sexually dimorphic pain processes in adults (Craft, Mogil, & Aloisi, 2004), research measuring facial expressivity associated with a heel prick suggests that neonatal girls are more sensitive to painful stimuli (Guinsburg et al, 2000), and properties of infant cries at 2 weeks to 6 months are consistent with greater pain reactivity in girls than in boys (Fuller, 2002). The auditory system is also sexually dimorphic in infancy and adulthood (McFadden, 1998), such that transientevoked otoacoustic emissions-sounds produced in the inner ear in response to acoustic stimuli-are weaker in males than in females.…”

Section: Basic and Sensory Processesmentioning

confidence: 78%

Sex Differences in Early Infancy

Alexander

Wilcox

2012

Child Dev Perspectives

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Sex‐linked behaviors in infancy have generated a great deal of interest, in part because they offer a way of assessing the extent to which sexually dimorphic behaviors exist before extensive social and educational experiences. This article reviews sex differences in basic and sensory processes, social behavior, and cognitive behavior that have been reported during the 1st year of life, and discusses current knowledge about the underlying basis for these differences and the extent to which they contribute to later behavior. Careful investigation of the interaction between social and biological factors in infancy will be necessary to fully understand the nature and development of human sex differences.

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“…Even though many studies have pinpointed the risk of being born a boy, no specific mechanisms for the increased risks have been identified. However, several studies have demonstrated the presence of early physiological gender differences in physiological and behavioural responses to delivery, pain and stress as well as differences in neonatal cerebral blood flow and heart rate (11)(12)(13). Still, the underlying mechanisms to why male gender is associated with increased neonatal mortality and morbidity is still unknown.…”

mentioning

confidence: 99%