Objective:

To synthesize long-term evidence on thermal and mechanical pain thresholds and pain intensity from school age to young adulthood in individuals born preterm compared to those born at term.

Approach:

• Data Sources: A systematic search was conducted in PubMed, Cochrane Library, Web of Science, and Scopus up to September 2025 for observational studies including preterm- and term-born participants aged 7–28 years.
• Study Selection: Studies were selected based on the PECO(S) framework, focusing on pain thresholds and alterations in pain perception related to prematurity.
• Meta-Analysis: Random-effects meta-analyses were performed using standardized or mean differences, with heterogeneity quantified using I2.

Key Findings:

• Preterm-born participants reported higher pain intensity (standardized mean difference = 0.45, p = 0.03) compared to term-born participants.
• Preterm-born individuals had higher heat pain thresholds (mean difference = 1.11 °C, p = 0.002) than term-born individuals.
• No significant differences were observed for other quantitative sensory testing outcomes.

Interpretation:

Preterm birth may be associated with differences in specific pain-related outcomes from childhood through young adulthood, particularly higher heat pain thresholds and pain intensity ratings.

Limitations:

• Substantial heterogeneity was observed in several analyses.
• The review included only observational studies, which may limit the strength of the conclusions.

Conclusion:

Well-designed longitudinal studies with standardized protocols are needed to inform neonatal pain management.

Sources:

• Systematic Review Registration