Early Transepidermal Water Loss in Term Neonates and Its Perinatal Influences Using a Closed-Chamber System

Area of Science:

• Neonatal dermatology
• Infant skin physiology
• Perinatal health

Background:

• The neonatal skin barrier is crucial for thermoregulation and protection.
• Understanding transepidermal water loss (TEWL) in newborns is key to assessing skin barrier function.
• Establishing normative TEWL values in the early postnatal period is essential.

Purpose of the Study:

• To determine transepidermal water loss (TEWL) values in healthy term neonates on day one.
• To investigate associations between TEWL and perinatal factors.
• To validate a closed-chamber system for TEWL measurement in neonates.

Main Methods:

• A cross-sectional study involving 120 healthy term infants (≥37 weeks gestation, 2-24 hours old).
• Non-invasive TEWL measurement using a standardized closed-chamber approach.
• Collated anthropometric and perinatal data, assessing device reliability (ICC=0.735).

Main Results:

• Mean TEWL was 13.9 ± 3.28 g/m²/h, with 5th-95th percentiles of 9.7-20.3 g/m²/h.
• Each additional postnatal hour correlated with a 0.11 g/m²/h reduction in TEWL.
• Caesarean section was associated with a 1.4 g/m²/h increase in TEWL; other factors showed no significant association.

Conclusions:

• Neonatal skin barrier function is uniformly competent at term, with low and variable TEWL.
• TEWL is not significantly influenced by typical ambient conditions or most common perinatal factors.
• Postnatal age and delivery mode are minor influencers of early neonatal TEWL.