Related Experiment Videos
Transepidermal water loss in infants born at 24 and 25 weeks of gestation
Insights
Transepidermal water loss (TEWL) is high in infants born at 24-25 weeks gestation immediately after birth. TEWL significantly decreases over the first 28 days, but at a slower rate than in more mature infants.
Area of Science:
- Neonatology
- Dermatology
- Physiology
Background:
- Infants born prematurely, particularly those at 24-25 weeks of gestation, have an immature skin barrier.
- High transepidermal water loss (TEWL) in preterm infants can lead to dehydration and electrolyte imbalances.
- Understanding TEWL dynamics is crucial for optimizing neonatal care and improving outcomes.
Purpose of the Study:
- To quantify transepidermal water loss (TEWL) in infants born at 24-25 weeks of gestation.
- To track the changes in TEWL during the first 28 days of postnatal life.
- To compare TEWL rates with previously reported data for preterm infants.
Main Methods:
- The study involved 13 infants born at 24 (n=3) and 25 (n=10) weeks of gestation.
- Water evaporation rate from the skin was measured using the gradient method on days 1, 1, 3, 7, and 28 postpartum.
- Transepidermal water loss (TEWL) was calculated and corrected to 50% ambient relative humidity.
Main Results:
- Transepidermal water loss (TEWL) was high on the first and second days postpartum (58.4 ± 14.8 and 59.3 ± 17.6 g m⁻² h⁻¹, respectively).
- TEWL significantly decreased over time, reaching 43.8 ± 9.5 g m⁻² h⁻¹ at 3 days, 36.1 ± 12.6 at 7 days, and 24.2 ± 7.7 g m⁻² h⁻¹ at 28 days (p < 0.001).
- No significant correlation was found between TEWL and birth weight, gender, mode of delivery, gestational age, or body/skin temperature.
Conclusions:
- Infants born at 24-25 weeks gestation exhibit high transepidermal water loss (TEWL) immediately after birth.
- TEWL gradually decreases in these extremely preterm infants over the first 28 days of life.
- The rate of TEWL reduction is slower compared to slightly more mature preterm infants, highlighting the vulnerability of their skin barrier.
Abstract:
The rate of evaporation of water from the skin of 13 infants born at 24 (n=3) and 25 (n=10) weeks of gestation was measured on the first day after birth and at postnatal ages of 1, 3, 7 and 28 d, using the gradient method. Transepidermal water loss was estimated from this rate and corrected to an ambient relative humidity (RH) of 50%. Transepidermal water loss, corrected to 50% RH, was high on the first day after birth (58.4+/-14.8 g m(-2) h(-1)) and remained at the same level during the second day (59.3+/-17.6 g m(-2)h(-1)). It then decreased significantly to 43.8+/-9.5 at a postnatal age of 3 d, 36.1+/-12.6 at 7 d and 24.2+/-7.7 g m(-2) h(-1) at 28 d (p < 0.001). Within the group investigated, there was no significant correlation between transepidermal water loss and body or skin temperature, birth weight, gender, mode of delivery or gestational age. Transepidermal water loss on the first day after birth was somewhat lower than the highest losses previously found in infants born at 25 weeks of gestation, and of the same magnitude as previously reported for infants born at 25-27 weeks. Transepidermal water loss at postnatal ages of 1, 3, 7 and 28 d in the present study was higher than that previously found in the group of infants born at 25-27 weeks. In conclusion, in infants born at 24-25 completed weeks of gestation transepidermal water loss was high immediately after birth and decreased with increasing postnatal age, but at a slower rate than previously reported for slightly more mature infants.