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32 Chronic Pain in the Newborn, A Delphi Survey to Define the Concept
  1. CJ van Ganzewinkel,
  2. P Andriessen
  1. Neonatology, Maxima Medical Center, Veldhoven, The Netherlands

Abstract

Chronic pain in the newborn has been poorly addressed in neonatal pain research. To date there is no clear definition. A three round, webbased Delphi survey aiming at providing a definition of chronic pain in the newborn was designed. We invited an international panel of experts in the field of neonatology and neonatal pain to participate.

Participants (n=189) answered in the first round three open-ended questions: (1) what is the definition of chronic pain, (2) what are possible causes and (3) what are the signs and symptoms? The answers were categorized into 437 statements. These statements were valued by the participants on a 5-point Likert scale in the second round. Statements with mode or median ≥ 4 and mean ≥ 3.75 were selected for analysis in the third round of the survey. These threshold values were used to provide the opportunity to reach consensus in subsequent rounds. In the third round the remaining participants (n=72) were asked to reflect on the group response regarding the remaining 65 statements. Provided with their own value from the previous round, the participants were able to revalue the statements. This process resulted in 34 statements with mode, mean and median of ≥ 4, in which the participants reached consensus.

Several etiologic factors were defined, but no useful diagnostic criterion could be identified. The Delphi survey resulted in a description of chronic pain in the newborn. Identifying chronic pain is clinically relevant because it interferes with growth, prolongs hospitalization and leads to altered pain perception.

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