A quantitative cross-sectional analysis of the melanin index in the skin of preterm newborns and its association with gestational age at birth.
BACKGROUND
Estimation of gestational age (GA) is important to make timely decisions and provide appropriate neonatal care. Clinical maturity scales to estimate GA have used skin texture and color to assess maturity at birth facing situations of the uncertainty of pregnancy dating. The size and darkness of the areola around the nipple to grade skin characteristics are based on visual appearance. The melanin index (M-Index) is an optical skin parameter related to the melanin content in the tissue. This study is aimed to associate the M-Index of the skin with the GA.


METHODS
A cross-sectional study evaluated 80 newborns at birth. A photometer device quantified the skin pigmentation on the areolae, forearms, and soles. Paired average differences of M-Index were compared among the three body sites. The skin M-Indexes were compared between subgroups of newborns until 34 weeks or with 34 and more.


RESULTS
The skin over the areola had the highest values of M-Index compared with the forearm or sole areas (P < .001 for both). Infants with a GA between 34 and <37 weeks had higher M-Index values over the areola than the group with a GA with 24 to <34 weeks: 41.7 (8.9) and 38.3 (10.5) median (IQR), P = .005.


CONCLUSIONS
The measurable M-Index values have the potential to improve physical evaluation in assessing GA at birth.
['Silva|Paola Conceição|PC|https://orcid.org/0000-0001-7589-7033', 'Guimarães|Rodney Nascimento|RN|', 'Souza|Rayner Guilherme|RG|', 'Reis|Zilma Silveira Nogueira|ZSN|https://orcid.org/0000-0001-6374-9295']
D001938:Brazil D016022:Case-Control Studies D003430:Cross-Sectional Studies D005260:Female D005865:Gestational Age D006801:Humans D007234:Infant, Premature D008297:Male D008543:Melanins D010783:Photometry D011247:Pregnancy D012867:Skin D012879:Skin Physiological Phenomena D012880:Skin Pigmentation
skin gestational age pigmentation infant photomedicine physiological phenomena premature