The Delicate Skin of Preterm Infants: Barrier Function, Immune-Microbiome Interaction, and Clinical Implications

Area of Science:

• Neonatal dermatology
• Microbiology
• Immunology

Background:

• Preterm infant skin exhibits distinct structural and functional characteristics compared to term infants.
• These differences increase susceptibility to injury, infection, thermal dysregulation, and transepidermal water loss.
• The development of skin barrier function, host immunity, and the skin microbiome are interconnected and vital for homeostasis.

Purpose of the Study:

• To review current knowledge on preterm infant skin development.
• To explore the interplay between skin immunity, barrier function, and the skin microbiome.
• To discuss potential clinical implications and identify knowledge gaps in preterm skin care.

Main Methods:

• Literature review of recent advances in molecular biology and dermatology.
• Analysis of studies investigating preterm skin structure, function, and microbiome.
• Synthesis of information on host-microbial interactions and environmental factors.

Main Results:

• Preterm skin undergoes rapid adaptation, with immune and microbial systems co-developing.
• Molecular biology advances reveal complex preterm skin microbiome composition and its relation to other body sites.
• Significant knowledge gaps exist regarding niche factors, environmental influences, and evidence-based skin care guidelines.

Conclusions:

• Further research is needed to understand factors influencing preterm skin maturation.
• Developing evidence-based guidelines for preterm infant skin care is essential.
• A comprehensive understanding of preterm skin biology is critical for improving infant outcomes.