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

To establish transepidermal water loss values on the first postnatal day in healthy term neonates and associations with perinatal factors utilising a closed-chamber system.

A cross-sectional single-centre study was conducted over a 7-month period. Healthy infants ≥ 37-week gestation and 2-24 h old were recruited. Transepidermal water loss was measured at a single time-point, non-invasively under typical ambient conditions using a standardised approach. Anthropometric and perinatal variables were collated. Outcomes assessed included device validity and reliability, transepidermal water loss values, and interactions with maternal and infant variables.

A total of 120 term infants were recruited. The intra-class correlation coefficient of three consecutive readings was 0.735, indicating good reliability. There was no interaction between transepidermal water loss and ambient conditions. Mean values were 13.9 ± 3.28 g/m²/h. The 5th and 95th percentiles were 9.7 and 20.3 g/m²/h, respectively. Each additional postnatal hour conferred a reduction in transepidermal water loss of 0.11 g/m²/h. Caesarean section increased transepidermal losses by 1.4 g/m²/h. No other associations were significant.

Early postnatal transepidermal water loss in the term infant is low but variable. Physiological variability is not attributable to typical ambient conditions or common perinatal factors, indicating a uniformly competent skin barrier at term.