Premature Infants With Pulmonary Complications Exhibit Decreased Skin Maturity Early After Birth: A Cross-Sectional Study.

INTRODUCTION

Early identification of respiratory risk in preterm newborns (PTNB) remains challenging, as direct assessment of pulmonary maturity is often unavailable or requires invasive or resource-intensive methods. Non-invasive biomarkers capable of indicating physiological maturity shortly after birth could improve early clinical decision-making in neonatal care. Because skin and lung development share common biological pathways, skin maturity assessed by optical reflectance may serve as an indirect marker of pulmonary development.

OBJECTIVE

This study evaluated the association between skin maturity estimated by skin reflectance and respiratory outcomes in PTNB during the first 48 hours of life.

METHODS

A cross-sectional study was conducted with PTNB born admitted within 48?h. Exclusion criteria included cutaneous malformations, or conditions interfering with dermal assessment. Skin maturity was measured using the non-invasive Preemie-Test® device. Respiratory outcomes, such as chest radiographic abnormalities, pneumothorax, atelectasis, and pulmonary hemorrhage, were defined by clinical and radiological criteria.

RESULTS

A total of 82 PTNB were included, 54.9% male. Skin reflectance ranged from 0.9 to 2.1?nm. Lower skin maturity was significantly associated with radiographic abnormalities (p = 0.01), pneumothorax (p = 0.01), pulmonary hemorrhage (p = 0.01), atelectasis (p = 0.01), and need for invasive ventilation (p = 0.01).

CONCLUSIONS

These findings suggest skin reflectance may serve as a rapid, objective, and non?invasive screening tool for neonatal respiratory risk.