The newborn pain cry: Descriptive acoustic spectrographic analysis

• Published in: International journal of pediatric otorhinolaryngology 2007-04, Vol.71 (4), p.539-546
• Main Authors: Branco, Anete, Fekete, Saskia M.W, Rugolo, Ligia M.S.S, Rehder, Maria Inês
• Format: Article
• Language: English
• Subjects: Acoustic analysis; Cough; Crying; Female; Humans; Infant Behavior; Infant, Newborn; Male; Newborn; Otolaryngology; Pain; Pain - etiology; Pain - psychology; Pain Measurement; Pediatrics; Phlebotomy - adverse effects; Phonation; Sound Spectrography; Venepuncture; Voice Quality
• ISSN: 0165-5876; 1872-8464
• DOI: 10.1016/j.ijporl.2006.11.009

Summary Introduction Study the characteristics of pain vocal emission of newborns during venepuncture through acoustic analysis and relate it to NIPS pain scale and some variables of the newborns. Methods Emissions of 111 healthy term newborns were recorded, whose lifetime varied from 24 to 72 h. The acoustic analysis was realized with GRAM 5.7 software verifying the occurrence of tense strangled voice quality, sounds, concentration of acoustic energy, breaks, double harmonic breaks and frequency instability, type of phonation, vocal attack and cough. The NIPS scale was realized during venepuncture and descriptive statistical analysis and correlation through Spearman test. Results Hundred percent of the emissions had guttural sounds, vowels, hard vocal attack, frequency, breaks, double harmonic breaks and tense strangled voice quality; 34.2% higher fundamental frequency; 62.2% periods of emission absence and 100% occurrence of tracing instability, concentration of acoustic energy, inspiratory and expiratory phonation. The cough occurred in 14.4%. The signs of vocal tract constriction associated with all the parameters. There was a negative correlation between the higher fundamental frequencies and the weight of newborns and positive correlation between cough and NIPS score. Conclusions The newborn pain emission is tense and strident, the modifications of frequency and spectrographic tracing and the presence of sounds show laryngeal and vocal tract participation. The smaller the newborn weight, the bigger the presence of higher fundamental frequency with tense strangled voice quality and the bigger the NIPS score, the more frequent the cough. Such characteristics make pain crying peculiar, helping in the evaluation of pain during a procedure.