Abstract
BackgroundEstimation 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.MethodsA 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.ResultsThe 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.ConclusionsThe measurable M‐Index values have the potential to improve physical evaluation in assessing GA at birth.
Highlights
Estimation of gestational age (GA) is important to make timely decisions and provide appropriate neonatal care
The melanin index (M-Index) is an optical skin parameter related to the melanin content in the tissue.[7]
The central contribution of this analysis was associating the color of the areola with the pregnancy chronology at birth using a quantitative assessment of melanin in the skin of neonates
Summary
The design of the study was an observational cross-sectional gathering of obstetric data, a clinical observation of the skin color in women, and an assessment of the M-Index in the skin of newborns using a noninvasive optical device. The color of the mother's skin was measured from the inner forearm using the Fitzpatrick reference.[8] This visual scale for skin phototypes ranged from 1 (pale light white) to 6 (very dark brown to black). Neonates had their skin reflectance assessed at three body sites, the anterior distal forearm, the sole of the foot, and the areola. When we stratified M-Index values by sex of the neonate infant, no significant differences were found between the mean (SD) value on areola 38.9 (5.7) in females vs 40.2 (8.8) in males, P = .456; on forearm 34.2 (5.3) in females vs 33.0 (5.7) in males, P = .358; neither on the sole 35.8 (5.8) in females vs 35.0 (5.7) in males, P = .525. In sequence, when analyzing statistical differences, comparisons among groups of prematurity ranges revealed a significant difference in the areolar M-Index of the group with GAs between 24 and
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