IMPLICATIONS OF NON-NUTRITIVE SUCKING FOR PAIN RELIEF IN PRETERM INFANTS: A SYSTEMATIC REVIEW AND META-ANALYSIS FOCUSED ON MATERNAL HEALTH AND LONG-TERM ATHLETIC DEVELOPMENT

Abstract

Background: Preterm infants often experience significant procedural pain during early hospitalization, necessitating effective pain management strategies. Non-nutritive sucking (NNS) has emerged as a promising non-pharmacological method to mitigate this pain. Despite its widespread use, comprehensive analyses of its efficacy are scant, particularly concerning long-term developmental outcomes which could influence future physical and athletic capabilities. Objective: This systematic review aims to assess the effectiveness of NNS in alleviating procedural pain in preterm infants, with an additional focus on potential implications for maternal health and long-term developmental outcomes. Methods: We conducted a systematic search across multiple databases including PubMed, Embase, and Cochrane Library, covering studies published up to July 20th, 2022. Two independent reviewers selected studies, extracted data, and assessed the risk of bias. The primary outcome was measured using the Premature Infant Pain Profile (PIPP), while secondary outcomes included heart rate and oxygen saturation. Meta-analysis was performed using a random-effects model to calculate pooled effects, with heterogeneity assessed via the chi-square test and I^2 method. Results: Out of 610 initially screened studies, 11 met the inclusion criteria and were further analyzed. Meta-analysis of 9 studies involving 990 participants indicated that NNS significantly reduced procedural pain based on PIPP scores compared to standard care (SMD -2.01; 95% CI -2.64, -1.37; I^2=92.62%). However, changes in heart rate and oxygen saturation during procedures did not show significant differences. Conclusion: NNS effectively reduces procedural pain in preterm infants, highlighting its value as a safe and non-invasive pain management strategy. Considering the implications for early pain experiences on long-term neurological development and subsequent physical abilities, these findings support broader integration of NNS in neonatal care. This approach not only benefits infant health but also may contribute to better long-term developmental outcomes, potentially influencing future athletic performance and physical resilience.