Newborn Transepidermal Water Loss and Gestational Age as Predictive Factors for Infant Atopic Dermatitis in the First Three Months of Age

Purpose Transepidermal water loss (TEWL) and stratum corneum hydration (SCH) are commonly used to assess epidermal barrier hydration. We investigated the associations of TEWL and SCH levels in newborns and the incidence of atopic dermatitis (AD) within the first 3 months of age. Methods We measured SCH and TEWL levels on the cheeks of 330 healthy full-term Vietnamese newborns within 48 hours after birth using a GPSkin Barrier Pro® device (GPOWER Inc., Korea). Subsequently, 233 newborns completed the follow-up via telephone calls over a period of 3 months. Any cases of AD and other skin disorders, including seborrheic dermatitis, diaper dermatitis, perianal dermatitis, or contact dermatitis that developed during the follow-up period, were recorded; AD was diagnosed based on the UK Working Party diagnostic criteria. Results A total of 233 newborns were followed up during the first 3 months of age, of whom 29 (12.4%) were diagnosed with AD. An increased risk of AD development was associated with higher TEWL levels within 48 hours after birth (adjusted risk ratio [aRR], 1.31; 95% confidence interval [CI], 1.14–1.51; P < 0.001) and longer gestational age (aRR, 2.71; 95% CI, 1.11–6.65, P = 0.029). A receiver operating characteristic curve analysis indicated that the TEWL levels could serve as a predictive factor for AD development in the first 3 months of life, with an area under the curve of 0.77 (95% CI, 0.67–0.86, P < 0.001). Conclusions The TEWL levels and gestational age within 48 hours after birth could serve as predictive factors for the development of AD in the first 3 months of life. This finding establishes a basis for the development of optimal prevention methods for AD.