Study of Neuropeptide Substance P as A Marker of Pain in Newborn Infant

Safaa ELMeneza; Iman  ElBagoury; Enas   Tawfik; Amel   Tolba

doi:10.3889/oamjms.2021.7444

Authors

Safaa ELMeneza Department of Pediatric, Faculty of Medicine for Girls, AL-Azhar University, Cairo, Egypt
Iman ElBagoury Department of Clinical Pathology, Faculty of Medicine for Girls, AL-Azhar University, Cairo, Egypt
Enas Tawfik Department of Pediatric, Faculty of Medicine for Girls, AL-Azhar University, Cairo, Egypt
Amel Tolba Department of Pediatric, Faculty of Medicine for Girls, AL-Azhar University, Cairo, Egypt

DOI:

https://doi.org/10.3889/oamjms.2021.7444

Keywords:

Pain, Newborn, Preterm, Full term, Substance P, Neonatal infant pain score, Long term outcome

Abstract

BACKGROUND: Prolonged and repeated untreated pain in newborn infant may produce a relatively permanent adverse long-term sequela.

AIM: The aim of this study was to evaluate the potential role for neuropeptides substance P (SP) as neurochemical pain marker in newborn infants in order to decrease unnecessary use of analgesics and protect the developing brain.

METHODS: This case-control study was conducted on 60 newborn infants. They were assigned to four groups, control preterm, sick preterm, control full term, and sick full term. All neonates were subjected to estimation of pain through neonatal infants pain score (NIPS) as well as Neuropeptide SP on the 1st and 5th day of life. The NIPS addresses five behavioral parameters (facial expression, crying, arm movement, leg movement, and state arousal) and one physiological parameter (breathing pattern). Results were further evaluated according to nature of the procedures; invasive and non-invasive procedures.

RESULTS: There was a significant increase in the severity of pain score among the sick preterm and full-term infants after invasive procedures. There was a significant increase in SP in the sick preterm group than the control preterm on the 1st and 5th day of life; p were =0.003 and = 0.037, while full-term infants showed significant increase on the 5th day; p = 0.005. Furthermore, there was no significant difference in SP values between the preterm and full-term infants on the 1st and 5th day of life. SP increased significantly after invasive procedures than noninvasive procedures in the sick full-term and sick preterm infants weather in the 1st or 5th day of life. There was a significant correlation between the pain score NIPS and SP level on the 1st day of life.

CONCLUSION: SP can be used as pain marker in sick preterm and full-term newborn infants. It showed increase with invasive procedures, acute and chronic pain.

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