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Clinical Nursing Research, Vol. 13, No. 1, 53-68 (2004)
DOI: 10.1177/1054773803259665

Salivary Cortisol As Indicators of Pain in Preterm Infants

A Pilot Study

Carolyn J. Herrington

Sparrow Health System, Michigan

Isoken N. Olomu

Michigan State University

Sandra M. Geller

Sparrow Health System, Michigan

Assessment and management of pain in preterm infants is critical and complicated. The addition of salivary cortisol measurement may improve the specificity of assessment and guide care to alleviate pain. The purpose of this study was fourfold: (a) assess the feasibility of a method of saliva collection in premature infants, (b) assess reliability of a method of measuring salivary cortisol in response to heelstick, (c) identify relationships between salivary cortisol and a measure of pain behavior (using CRIES) following heelstick, and (d) identify peak response times for elevations of salivary cortisol following heelstick in preterm infants. This was a prospective, descriptive pilot study. Serial saliva samples were collected from eight healthy infants 30 to 36 weeks’ gestational age in a Newborn Intensive Care Unit. Cortisol levels were determined using enzyme-immuneassay. Samples were collected without use of stimulants. Sample means supported peak and trough patterns previously described in the literature. Behavioral measures of pain did not correlate well with peak cortisol levels.

Key Words: salivary cortisol • newborn • pain • stress • premature infants


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E. Morelius, E. Theodorsson, and N. Nelson
Salivary Cortisol and Mood and Pain Profiles During Skin-to-Skin Care for an Unselected Group of Mothers and Infants in Neonatal Intensive Care
Pediatrics, November 1, 2005; 116(5): 1105 - 1113.
[Abstract] [Full Text] [PDF]