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Transcutaneous Microcirculatory Imaging in Preterm Neonates
Published on: December 31, 2015
Changes in diapered and nondiapered infant skin over the first month of life
M O Visscher1, R Chatterjee, K A Munson
1Skin Sciences Institute, Children's Hospital Research Foundation, University of Cincinnati, Ohio, USA.
Insights
Newborn skin barrier properties mature significantly in the first 28 days, with distinct changes in hydration and pH. Diapered skin shows unique development compared to nondiapered areas and adult skin.
Area of Science:
- Neonatal dermatology
- Developmental biology
- Skin physiology
Background:
- The neonatal epidermis possesses unique properties that differ from adult skin.
- Understanding the maturation of the skin barrier in newborns is crucial for infant care and product development.
Purpose of the Study:
- To investigate the time- and site-dependent changes in epidermal barrier properties of healthy term newborn infants over the first 28 days of life.
- To compare diapered and nondiapered skin sites in newborns with adult volar forearm skin.
Main Methods:
- Longitudinal study of 31 term infants from day 1 to day 28 postpartum.
- Measurements included skin hydration, capacitive reactance, water sorption/desorption, pH, and temperature.
- Comparison between diapered, nondiapered infant skin, and maternal volar forearm skin.
Main Results:
- Newborn skin showed increased hydration, decreased transepidermal water movement, slower water desorption, and decreased pH over 28 days.
- Diapered and nondiapered sites differed after 14 days, with diapered skin exhibiting higher pH and hydration.
- Maternal skin measurements remained stable throughout the study period.
Conclusions:
- Healthy newborn skin undergoes progressive epidermal barrier maturation during the first month of life.
- Diapering influences neonatal skin barrier development, leading to site-specific differences.
- Adult skin models are not representative of neonatal skin during the first month postpartum.
Abstract:
Time- and site-dependent differences in epidermal barrier properties were investigated over the first 28 days of life in healthy term newborn infants. Diapered and nondiapered skin sites were contrasted to the volar forearm of adults (mothers). Thirty-one term infants were evaluated in the hospital on postnatal day 1 and at home on days 4, 7, 14, 21, and 28 for a total of six visits. Measurements included baseline skin hydration, continuous capacitive reactance, peak water sorption, rate of water desorption, skin pH, skin temperature, and environmental conditions. Changes in epidermal barrier properties over the first 4 weeks of life included an increase in surface hydration, a decrease in transepidermal water movement under occlusion, a decrease in surface water desorption rate, and a decrease in surface pH. Diapered and nondiapered regions were indistinguishable at birth but exhibited differential behavior over the first 14 days, with the diapered region showing a higher pH and increased hydration. Maternal measurements remained constant throughout the period. We conclude that healthy newborn skin undergoes progressive changes in epidermal barrier properties over the first 28 days. Adult skin testing does not replicate newborn skin during the first month of life.
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