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Perceived maternal information on premature infant’s pain during hospitalization: the French EPIPAGE-2 national cohort study



Parents of preterm neonates wish greater involvement in pain management; little is known about factors associated with this involvement. We aim to describe perceived maternal information on infants’ pain during hospitalization (PMIP), to study associations between PMIP and mothers’ attitudes during painful procedures, and to identify individual and contextual factors associated with PMIP.


Analyses of questionnaires from the French national cohort study of preterm neonates, EPIPAGE-2. PMIP was derived from mothers’ answers to questions about information perceived on both pain assessment and management.


Among 3056 eligible neonates born before 32 weeks, 1974, with available maternal reports, were included in the study. PMIP was classified as “sufficient,” “little, not sufficient,” or “insufficient, or none” for 22.7, 45.9, and 31.3% of neonates, respectively. Mothers reporting PMIP as “sufficient” were more frequently present and more likely comforting their child during painful procedures. Factors independently associated with “sufficient” PMIP were high maternal education, gestational age <29 weeks, daily maternal visits, perception of high team support, and implementation of the neonatal and individualized developmental care and assessment program.


Perceived maternal information on premature infants’ pain reported as sufficient increased maternal involvement during painful procedures and was associated with some units’ policies.

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Members of the Neurodevelopmental Care Study Group of EPIPAGE-2 are listed at the end of the paper.


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We thank members of the EPIPAGE-2 study group and all the regional teams participating in the study for their substantial contribution to acquisition of data; Diep Tran for administration of the EPIPAGE-2 database and provision of the data; Laura Smales for her helpful contribution in providing language help. We are grateful for the participation of all families of preterm infants in the EPIPAGE-2 cohort study and for the cooperation of all maternity and neonatal units in France. This work was supported by (1) The French Institute of Public Health research/institute of Public Health and its partners: the French Health Ministry, the National institute of Health and Medical Research (INSERM). (2) The French EQUIPEX program of investments in the future coordinated by the National Research Agency. (3) The Fondation de France No. 00050329.

Author information

V.P., L.M.-M., L.V., and P.-Y.A. had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. V.P., L.M.-M., L.V., M.K., R.C., and P.-Y.A conceptualized the study and wrote the manuscript. L.M.M. and L.V. performed the statistical analysis. M.D. coordinated data collection and had responsibility for technical support. P.-Y.A. obtained funding and supervised the study. All authors contributed to the plan analysis and interpretation of the results, and reviewed and approved the final manuscript. All members of the neurodevelopmental care study group were involved in the regional organization for data collection, reviewed, and approved the final manuscript.

Neurodevelopmental Care Study Group of EPIPAGE -2

C. Arnaud10,11,12, A. Burguet4, L. Caeymaex13, G. Cambonie5, V. Datin-Dorrière7, C. Gire14, B. Guillois7, P. Kuhn6, A. Mitha15, H. Patural16, J. C. Roze17,18, J. M. Roué19, V. Pierrat1,2

Competing interests

The authors declare no competing interests.

Correspondence to Véronique Pierrat.

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