Grant: Travel Awards - Institute Community Support

Although heart rate is a common measure of infant pain, few studies have examined how heart rate responses to pain develop over the first year of life. Therefore, our ability to understand and manage infant pain is hindered. The current comprehensive review aims to chart the development of heart rate responses to needle pain in preterm infants over the first year of life. A comprehensive search was conducted in four search engines. After removing duplicate articles, 6994 studies were assessed for eligibility to be descriptively analyzed in the review. Search results were limited to evidence-based methodologies, publication years (1980+), and age group (0-3 years). Thirteen studies were first separated by gestational age (GA) at birth (24-28, 28-32, 32-37 weeks). These groups were then qualitatively synthesized based on age at measurement. During the first week of life, a blunted heart rate (HR) response to needle pain was found in extremely premature infants (24-28 weeks GA). From 1 to 4 months, the extremely premature infants had increased heart rate following needle pain. In older infants (28-37 weeks GA), heart rate was variable over the first 4 months of life, but significantly increased in response to needle pain. When examining studies of preterm infants from 0- 4 months of age, cardiovascular responses to needle pain qualitatively differed based on gestational age. Longitudinal research examining preterm infants' heart rate response to needle pain over the first year of life is necessary to understand how premature infants physiologically respond to pain over time. Research in this area will lead to empirically based evaluation and treatment of preterm infants' pain