# BIO-BEHAVIORAL MARKERS OF INFANT PAIN AND TEMPERAMENT

> **NIH NIH R01** · WASHINGTON UNIVERSITY · 1994 · $252,180

## Abstract

This proposal describes a research program which extends our previous
work on pain in the human newborn infant by studying pain reactivity to
varied stimuli in a developmentally and clinically diverse sample of
infants within and beyond the neonatal period.  To study pain, we will
systematically measure physiologic, behavioral and acoustic parameters
of newborn infants in response to invasive, clinically-required beside
procedures or parentally-requested circumcision surgery during their
hospitalizations.  The 250 subjects will include premature and full term,
healthy and sick infants, with and without brain injury, with and without
assisted mechanical ventilation, who have been recruited for study
shortly after admission to a Level I, II or III nursery.  Our primary
measures include mean heart rate, blood pressure, vagal tone, oxygen
saturation, cry fundamental frequency and the presence of a "cry face"
expression.  Studies will be conducted for all infants in response to a
clinically-required heel stick procedure shortly after admission and,
subsequently, in response to at least two additional procedures to
include a lumbar puncture, intravenous line placement or circumcision
surgery and a physical exam.  Subjects will be studied during additional
clinically-required invasive procedures during hospitalization.  To
assess the acute and more prolonged effects of pain, we will conduct a
randomized controlled trial in healthy, full term infants to examine how
anesthesia for circumcision surgery alters response to a post-
circumcision heel stick.  At six months, a subsample of 100 infants will
be studied during a laboratory temperament assessment and a physical
exam.  Together, these studies will allow us to 1) quantify the influence
of neonatal characteristics, perinatal events and stimulus invasiveness
on neonatal pain reactivity; 2) construct a stimulus-response gradient
of infant pain which can be compared with adult-based models and
perceptions of pain; 3) determine whether early reactions to pain predict
subsequent reactivity; and 4) quantify the relation between physiologic
reactivity and infant temperament.  The proposed studies respond directly
to the public health need for special pain expertise to be developed for
the care of newborn and, especially, premature infants.  Special
attention is focused on the development of an accurate, multidisciplinary
assessment of infant pain and on patient outcome.  These studies will
generate research data which are directly translatable into clinical
decisions at the bedside.  The proposed research provides an opportunity
to make major advances in our understanding of pain in newborn infants
and how best to manage it.

## Key facts

- **NIH application ID:** 2198010
- **Project number:** 2R01HD020414-06A1
- **Recipient organization:** WASHINGTON UNIVERSITY
- **SAM.gov UEI:** L6NFUM28LQM5
- **Principal Investigator:** Fran Lang
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 1994
- **Award amount:** $252,180
- **Award type:** 2
- **Project period:** 1986-08-01 → 1998-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/2198010

## Citation

> US National Institutes of Health, RePORTER application 2198010, BIO-BEHAVIORAL MARKERS OF INFANT PAIN AND TEMPERAMENT (2R01HD020414-06A1). Retrieved via MORVS 2026-10-25 from https://api.morvs.ai/grant/nih/2198010. Licensed CC0.

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