Neonatal Dermatologic Findings in Uruguay: Epidemiology and Predisposing Factors

Abstract

BackgroundThe skin is a fundamental organ in the transition from intrauterine to extrauterine life. The newborn infant experiences physiological changes and often presents benign, transient skin characteristics that vary according to maternal, gestational, and neonatal factors. ObjectivesTo estimate the frequency of various dermatologic findings during the first 72 hours of life and to identify their association with maternal, gestational, or neonatal factors. MethodsDescriptive, observational, cross-sectional study from April to July 2015 and July to November 2017 in the maternity ward of Centro Hospitalario Pereira Rossell. We examined the skin of neonates within 72 hours of birth. Proportions and 95% CIs were calculated for all findings. Associations between findings and factors were analyzed. ResultsA total of 2811 neonates were included. We observed at least 1 neonatal skin finding in all of the neonates and found a median (interquartile range) of 8 (6–9) findings (minimum–maximum, 1–16). We observed 42 of the 46 possible characteristics we looked for; 99.9% of the findings were benign and transient. Among the findings were lanugo (98%; 95% CI, 97.7%–98.7%), physiological scaling (79.7%; 95% CI, 78.2%–81.1%), and sebaceous hyperplasia (73.3%; 95% CI, 71.6%–74.9%). Lanugo (P = .001), physiological scaling (P < .001), and erythema toxicum (P = .001) were observed significantly more often in full- and late-term neonates. Sebaceous hyperplasia (P = .001) and transient hyperpigmentation (P < .001) were found more often in newborn males. Erythema toxicum was more common after vaginal births (P = .008). Transient hyperpigmentation (P < .001) and dermal melanocytosis (P < .001) were seen more often in neonates of African descent. ConclusionsAll neonates have skin characteristics that are part of their adaptation to extrauterine life. Most are benign and transient. Maternal age, type of delivery, and certain neonatal factors such as gestational age, birth weight, sex, and ethnicity are associated with specific findings.