{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T12:11:00Z","timestamp":1780315860266,"version":"3.54.1"},"reference-count":24,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T00:00:00Z","timestamp":1775433600000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Early identification of respiratory risk in preterm newborns (PTNB) remains challenging, as direct assessment of pulmonary maturity is often unavailable or requires invasive or resource\u2010intensive methods. Non\u2010invasive biomarkers capable of indicating physiological maturity shortly after birth could improve early clinical decision\u2010making in neonatal care. Because skin and lung development share common biological pathways, skin maturity assessed by optical reflectance may serve as an indirect marker of pulmonary development.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study evaluated the association between skin maturity estimated by skin reflectance and respiratory outcomes in PTNB during the first 48 hours of life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross\u2010sectional study was conducted with PTNB born admitted within 48?h. Exclusion criteria included cutaneous malformations, or conditions interfering with dermal assessment. Skin maturity was measured using the non\u2010invasive Preemie\u2010Test\u00ae device. Respiratory outcomes, such as chest radiographic abnormalities, pneumothorax, atelectasis, and pulmonary hemorrhage, were defined by clinical and radiological criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 82 PTNB were included, 54.9% male. Skin reflectance ranged from 0.9 to 2.1?nm. Lower skin maturity was significantly associated with radiographic abnormalities (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01), pneumothorax (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01), pulmonary hemorrhage (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01), atelectasis (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01), and need for invasive ventilation (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings suggest skin reflectance may serve as a rapid, objective, and non?invasive screening tool for neonatal respiratory risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71562","type":"journal-article","created":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T13:10:14Z","timestamp":1775481014000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Premature Infants With Pulmonary Complications Exhibit Decreased Skin Maturity Early After Birth: A Cross\u2010Sectional Study"],"prefix":"10.1002","volume":"61","author":[{"given":"Samanta Cris Monteiro","family":"Frota","sequence":"first","affiliation":[{"name":"Januario Cicco Teaching Maternity, Brazilian Hospital Services Company (EBSERH) Federal University of Rio Grande do Norte Natal Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiza Eduarda Silva de","family":"Macedo","sequence":"additional","affiliation":[{"name":"Januario Cicco Teaching Maternity, Brazilian Hospital Services Company (EBSERH) Federal University of Rio Grande do Norte Natal 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Guerra","family":"Azevedo","sequence":"additional","affiliation":[{"name":"Vicerrector\u00eda Acad\u00e9mica \u2010 Universidad Cat\u00f3lica de Temuco, La Araucan\u00eda Temuco Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"APPLE Consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta Lins","family":"Gon\u00e7alves","sequence":"additional","affiliation":[{"name":"Federal University of Amazonas and Federal University of Juiz de Fora Manaus and Juiz de Fora Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5354-5456","authenticated-orcid":false,"given":"Daniele","family":"Soares\u2010Marangoni","sequence":"additional","affiliation":[{"name":"Federal University of Mato Grosso do Sul Campo Grande Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela 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