Assessment of skin maturity by LED light at birth and its association with lung maturity: clinical trial secondary outcomes

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dc.creatorGabriela Silveira Neves
dc.creatorZilma Silveira Nogueira Reis
dc.creatorRoberta Romanelli
dc.creatorJames Batchelor
dc.date.accessioned2025-02-11T19:57:11Z
dc.date.accessioned2025-09-08T23:33:32Z
dc.date.available2025-02-11T19:57:11Z
dc.date.issued2023-12-25
dc.format.mimetypepdf
dc.identifier.issn2561-3278
dc.identifier.urihttps://hdl.handle.net/1843/79916
dc.languageeng
dc.publisherUniversidade Federal de Minas Gerais
dc.relation.ispartofJMIR Biomedical Engineering
dc.rightsAcesso Aberto
dc.subjectFotometria
dc.subjectRecém-nascidos
dc.subjectTratamento respiratório para recém-nascidos
dc.subject.otherNewborn infant
dc.subject.otherPrematurity
dc.subject.otherNeonatal respiratory distress syndrome
dc.subject.otherSkin physiological phenomena
dc.subject.otherPhotometer
dc.subject.otherGestational age
dc.titleAssessment of skin maturity by LED light at birth and its association with lung maturity: clinical trial secondary outcomes
dc.typeArtigo de periódico
local.citation.epage13
local.citation.spage1
local.citation.volume8
local.description.resumoBackground: Clinicians face barriers when assessing lung maturity at birth due to global inequalities. Still, strategies for testing based solely on gestational age to predict the likelihood of respiratory distress syndrome (RDS) do not offer a comprehensive approach to addressing the challenge of uncertain outcomes. We hypothesize that a noninvasive assessment of skin maturity may indicate lung maturity. Objective: This study aimed to assess the association between a newborn’s skin maturity and RDS occurrence. Methods: We conducted a case-control nested in a prospective cohort study, a secondary endpoint of a multicenter clinical trial. The study was carried out in 5 Brazilian urban reference centers for highly complex perinatal care. Of 781 newborns from the cohort study, 640 were selected for the case-control analysis. Newborns with RDS formed the case group and newborns without RDS were the controls. All newborns with other diseases exhibiting respiratory manifestations were excluded. Skin maturity was assessed from the newborn's skin over the sole by an optical device that acquired a reflection signal through an LED sensor. The device, previously validated, measured and recorded skin reflectance. Clinical data related to respiratory outcomes were gathered from medical records during the 72-hour follow-up of the newborn, or until discharge or death, whichever occurred first. The main outcome measure was the association between skin reflectance and RDS using univariate and multivariate binary logistic regression. Additionally, we assessed the connection between skin reflectance and factors such as neonatal intensive care unit (NICU) admission and the need for ventilatory support. Results: Out of 604 newborns, 470 (73.4%) were from the RDS group and 170 (26.6%) were from the control group. According to comparisons between the groups, newborns with RDS had a younger gestational age (31.6 vs 39.1 weeks, P<.001) and birth weight (1491 vs 3121 grams, P<.001) than controls. Skin reflectance was associated with RDS (odds ratio [OR] 0.982, 95% CI 0.979-0.985, R2=0.632, P<.001). This relationship remained significant when adjusted by the cofactors antenatal corticosteroid and birth weight (OR 0.994, 95% CI 0.990-0.998, R2=0.843, P<.001). Secondary outcomes also showed differences in skin reflectance. The mean difference was 0.219 (95% CI 0.200-0.238) between newborns that required ventilatory support versus those that did not and 0.223 (95% CI 0.205-0.241) between newborns that required NICU admission versus those that did not. Skin reflectance was associated with ventilatory support (OR 0.996, 95% CI 0.992-0.999, R2=0.814, P=.01) and with NICU admission (OR 0.994, 95% CI 0.990-0.998, R2=0.867, P=.004). Conclusions: Our findings present a potential marker of lung immaturity at birth using the indirect method of skin assessment. Using the RDS clinical condition and a medical device, this study demonstrated the synchrony between lung and skin maturity.
local.identifier.orcidhttps://orcid.org/0000-0001-6765-2968
local.identifier.orcidhttps://orcid.org/0000-0001-6374-9295
local.identifier.orcidhttps://orcid.org/0000-0002-1660-0751
local.identifier.orcidhttps://orcid.org/0000-0002-5307-552X
local.publisher.countryBrasil
local.publisher.departmentMED - DEPARTAMENTO DE GINECOLOGIA OBSTETRÍCIA
local.publisher.departmentMED - DEPARTAMENTO DE PEDIATRIA
local.publisher.initialsUFMG
local.url.externahttps://biomedeng.jmir.org/2023/1/e52468

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