Association Between Neonatal Pain Exposure and Neurodevelopmental Outcomes in Very Preterm Infants During the COVID-19 Pandemic: A Retrospective Observational Study

Background: Research on preterm infant development during the coronavirus disease 2019 (COVID-19) pandemic has yielded inconsistent results and has not considered the impact of exposure to pain. This study aimed to investigate the association between neurodevelopment in very preterm infants and pain exposure during the COVID-19 pandemic. Methods: This retrospective study included very preterm infants born before 33 weeks’ gestation between 2017 and 2022. Their neurodevelopmental status was assessed using the Kyoto Scale of Psychological Development at corrected 18 months (n = 92) and 36 months (n = 82) (n = 35 and 23 during the COVID-19 pandemic, respectively). Results: Multiple regression analysis adjusted for confounding factors showed that the developmental quotient at corrected 18 months was not associated with parental visit frequency or invasive procedure count. At 36 months, it was also not associated with parental visit frequency; however, in the cognitive–adaptive domain, it showed a significant association with the number of invasive procedures (B = −0.10; β = −0.45; 95% confidence interval [−0.76, −0.14]; p = 0.0049). Conclusions: These findings highlight the importance of maintaining neonatal pain management during disease outbreaks to support neurodevelopmental outcomes in very preterm infants.