Pain assessment in very low birth weight preterm neonates with severe intraventricular hemorrhage

We aimed to investigate if severe intraventricular hemorrhage (IVH) is associated with pain in very low birth weight neonates (VLBWN). Historical prospective study in a level III neonatal intensive care unit including subsequent neonates with birth weight (BW) less than 1500g and gestational age (GA) less than 32 weeks from 2020 to 2022. Neonatal Pain, Agitation, and Sedation Scale (NPASS) was used. Bivariate and multivariate analyses were performed. 172 newborns were included. Mean BW and GA were 989g and 28 weeks. Grade III IVH and periventricular hemorrhagic infarction (PHI) incidence was 7 % and 8 %, respectively. PHI, Grade III IVH and lower BW were associated with higher adjusted cumulative mean of the NPASS score until day three of life. The lower the BW, the higher the adjusted score until day seven. This study suggests an association between pain and severe IVH, most significant until day three of life.