Children born preterm display altered sensory processing, which may manifest as hyper- and/or hypo-sensitivity to sensory information. In this vulnerable population, exposure to neonatal pain-related stress is associated with altered stress regulation, as indexed by alterations in cortisol levels. It is unknown whether sensory processing behaviors are also affected by early life adversity, and whether dysregulated cortisol is related to sensory processing problems in preterm children. We examined relationships between neonatal pain-related stress, sensory processing profiles and cortisol levels at age 4 years, and whether pathways were sex-specific. In a longitudinal prospective cohort study, N = 146 infants born 24–32 weeks gestational age were recruited from BC Women's Hospital, Vancouver, BC, Canada; neonatal factors were collected from daily chart review. At age 4 years, saliva to assay cortisol was collected three times across cognitive assessment (pre-test, during, end) and parents completed the Short Sensory Profile questionnaire. Using generalized linear modeling, independent of other neonatal factors, higher number of invasive procedures (pain/stress) was associated with more sensory processing problems (total, hypo- and hyper-sensitivity) for girls only. After accounting for neonatal factors, greater cortisol output across the assessment was associated with more total sensory processing problems in girls only, and hypersensitivity to sensory input in both boys and girls. Findings suggest that in children born very preterm, how a child responds to sensory input and cortisol reactivity to stress are related but may have different precursors. Girls may be somewhat more susceptible to neonatal pain-related stress exposure in relation to sensory processing at preschool age.

中文翻译：

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4 岁时的感觉处理和皮质醇：早产儿的程序性疼痛相关压力

早产儿表现出感觉处理发生改变，这可能表现为对感觉信息的高敏感性和/或低敏感性。在这一弱势群体中，暴露于新生儿疼痛相关的压力与压力调节的改变有关，这可以通过皮质醇水平的变化来衡量。尚不清楚感觉处理行为是否也受到早期生活逆境的影响，以及皮质醇失调是否与早产儿的感觉处理问题有关。我们检查了 4 岁时新生儿疼痛相关压力、感觉处理特征和皮质醇水平之间的关系，以及通路是否具有性别特异性。在一项纵向前瞻性队列研究中，N = 146 名胎龄为 24-32 周的婴儿从加拿大不列颠哥伦比亚省温哥华的 BC 妇女医院招募；从每日图表回顾中收集新生儿因素。在 4 岁时，通过认知评估（测试前、测试期间、结束）收集了 3 次唾液以测定皮质醇，并且父母完成了简短的感觉概况问卷。使用广义线性模型，独立于其他新生儿因素，更多的侵入性操作（疼痛/压力）仅与女孩更多的感觉处理问题（总、低敏感和高敏感）相关。在考虑了新生儿因素后，整个评估中更多的皮质醇输出仅与女孩的总体感觉处理问题以及对感觉输入的超敏反应有关在男孩和女孩中。研究结果表明，在早产儿中，孩子对感觉输入的反应和皮质醇对压力的反应是相关的，但可能有不同的前兆。与学龄前儿童的感觉处理相关，女孩可能更容易受到与新生儿疼痛相关的压力暴露的影响。