Electrodermal activity monitoring in newborns during the early neonatal period depending on their health status

Despite the research conducted in recent years, it remains difficult to assessing the intensity of stress and pain due to the limited ability of newborn children to express discomfort in the absence of verbal communication, and methods for assessing hormonal regulation, metabolism and homeostasis are invasive and unsuitable for continuous monitoring.
Objective. To assess the reaction of the sympathetic nervous system in newborns in the early neonatal period, depending on their state of health, by recording electrodermal activity (EDA).
Material and methods. During the work, electrodermal activity indicators were monitored in 160 newborns of gestational age 37–40 weeks, who were divided into two groups: Group 1 included 80 healthy newborns, while Group 2 comprised 80 newborns with perinatal pathology. To monitor the indicators of electrodermal activity, the NeonFSC system (manufactured by «VKO Physiomed ») was used, the software of which enables the assessment of the following skin conduction reactions: — spectral power of the skin conduction reaction «IP»; cumulative stress effect DASS; sympathetic dominance index SDI; reactivity index PVI on the distal parts of the limbs of newborns.
Results. Perinatal pathology in group 2 newborns was presented by: intrauterine hypoxia/asphyxia at birth (70%), respiratory insufficiency (57.6%), congenital pneumonia (45%), growth retardation and malnutrition (15%), congenital heart defects in the form of ventricular septal defects (12.5%), diabetic fetopathy (7.5%), cephalohematomas and hemolytic disease due to Rh factor incompatibility (5% each). It was found that in newborns of group 2, such pathological electrodermal activity patterns as cumulative stress effect (р=0,0016) and types 3 and 4 of scattergrams were statistically significantly more often than in children of group 1 (р<0,001). Thus, the reaction of the sympathetic department of the vegetative nervous system, obtained as a result of monitoring electrodermal activity indicators, in newborns in the early neonatal period depended on their state of health.
Conclusion. The association between pathological electrodermal activity patterns and the severity of neonatal conditions makes it possible to use them as criteria for neonatal distress, which, according to the results of the study, are an increase in the cumulative effect of stress above 75 centiles, as well as types 3 and 4 of the scattering scale.

1. Kireev S.S. Pain and stress in the newborn. Vestnik novyh medicinskih tehnologij 2016; 23(4): 328–342. (in Russ.)

2. Brewer C.L., Baccei M.L. The development of pain circuits and unique effects of neonatal injury. J Neural Transm (Vienna). 2020; 127(4): 467–479. DOI: 10.1007/s00702–019–02059-z

3. Akarachkova E.S., Baidauletova A.I., Belyaev A.A., Blinov D.V., Gromova O.A., Dulaeva M.S. et al. Stress: causes and consequences, treatment and prevention. Clinical recommendations. St. Petersburg: Scythia-print; Moscow: Profmedpress, 2020; 138. (in Russ.)

4. Kurzanov A.N., Zabolotskikh N.V., Kovalev D.V. Functional reserves of the body, monograph. Moscow: Publishing House of the Academy of Natural Sciences, 2016; 96. (in Russ.)

5. Ranger M., Synnes A.R., Grunau R.E. Interanalizing behaviours in scool-age children born very preterm are predicted by neonatal pain and morphine exposure. Eur J Pain (London, England) 2014; 18(6): 844–852. DOI: 10.1002/j.1532–2149.2013.00431.x

6. Victoria Nicole C., Murphy Anne Z. The long-term impact of early life pain on adult responses to anxiety and stress: Historical perspectives and empirical evidence. Exper Neurol 2016; 275Pt(Pt2): 261–273. DOI: 10.1016/j.expneurol.2015.07.017

7. Williams Morika D., Lascelles B., Duncan X. Early Neonatal Pain — A Review of Clinical and Experimental Implications on Painful Conditions Later in Life. Front Pediatr 2020; 8(30): 1–18. DOI: 10.3389/fped.2020.00030

8. Alexandrovich Yu.S., Gordeev V.I. Evaluation and diagnostic scales in critical condition medicine. St. Petersburg: ELBI-SPB, 2021; 320. (in Russ.)

9. Andreev A.V., Kharlamova N.V., Menzhinsky S.S., Shylova N.A., Karpova A.L., Mostovoy A.V. et al. Problems of clinical assessment of pain in newborn children. Rossiyskiy vestnik perinatologii i pediatrii 2020; 65(4): 5–15. (in Russ.) DOI: 10.21508/1027–4065–2020–65–4–5–15

10. Llerene A., Tran K., Choudnary D., Hausmann Y., Goldgof D., Sun Y., Prescott S.M. Neonatal pain assessment: Do we have the right tools? Front Pediatr. 2023; 10: 1022751. DOI: 10.3389/fped.2022.1–22751

11. D’Agata A.L., Roberts M.B., Ashmeade T., Ozorio Dutra S.V., Kane B., Groer M.W. Novel method of measuring chronic stress for preterm infants: skin cortisol. Psychoneuroendocrinology 2019; 102: 204–211. DOI: 10/1016/j. psyneuen.2018.12.223

12. Vane A.M., Golubev V.L. Vegetative disorders: clinic, treatment, diagnosis: A guide for doctors. Moscow: Medical Information Agency, 2010; 640. (in Russ.)

13. Visnovcova Z., Kozar M., Kuderava Z., Zibolen M., Ferencova N., Tonhayzerova I. Entropy Analysis of Neonatal Electrodermal Activity during the First Three Days after Birth. Entropy (Basel). 2022; 24(3): 422. DOI: 10.3390/e24030422

14. Cook K.M., De Asis-Cruz J., Kim J.H., Basu S.K., Andescavage N., Murnick J., et al. Experience of early-life pain in premature infants is associated with atypical cerebellar development and later neurodevelopmental deficits. BMC Med 2023; 21(1): 435. DOI: 10.1186/s12916–023–03141-w