Pain is defined as “an unpleasant sensory and emotional experience associated
with actual or potential tissue damage, or described in terms of such damage”
(IAS P, 1979). Chronic pain of at least 3 months duration is quite common in
children and even in toddlers. Levels and duration of acute pain and distress
during medical procedures are high as well. Furthermore, there are significant
consequences of both acute and chronic pain, such as an altered pain perception
after high acute pain that increases fear and pain in future procedures, and
impaired daily functioning and quality of life in children with chronic pain. Thus,
it is important to gain understanding of what determinants might affect differences
in children’s procedural distress and chronic pain. Theoretical models
and previous evidence show various parent factors, such as anxiety, depression,
and chronic pain, and child factors, such as temperament, as determinants of
pediatric acute and chronic pain. Most studies so far have investigated children
aged 3 or older and many have used clinical samples and/or cross-sectional
designs. As a consequence, it is not clear what the early longitudinal risk factors
are for toddlers’ pain.
The aim of this thesis was to extend existing knowledge on prenatal and
early postnatal determinants of young children’s acute pain and chronic pain.
The studies presented in this dissertation were carried out within the Generation
R Study, a prospective multi-ethnic population-based study investigating
growth, development and health from fetal life onwards in Rotterdam, the
Netherlands.http://repub.eur.nl/res/pub/23427/Omslag%20proefschrift%20NJ%20Wolff.pdf
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