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In newborns, serum biomarker concentrations are strongly influenced by gestational and postnatal age, reflecting dynamic developmental and inflammatory processes. This review highlights the importance of gestational and postnatal age\u2010based interpretation of neonatal serum biomarkers, using albumin, immunoglobulin G (IgG), and interleukin\u20106 (IL\u20106) as representative examples. Albumin concentrations at birth correlate more closely with gestational age than with birth weight, likely reflecting maturation of fetal hepatic synthetic capacity, whereas postnatal albumin levels increase with fluid redistribution, nutritional status, and physiological adaptation, leading to wide variability that limits the utility of fixed thresholds. Similarly, IgG concentrations at birth are primarily determined by gestational age\u2010dependent placental transfer and remain low for prolonged periods in preterm infants, complicating assessment of immune vulnerability and immunoglobulin supplementation. IL\u20106 is a sensitive indicator of inflammatory activity; however, gestational age influences the magnitude of IL\u20106 responses to fetal inflammation, particularly in extremely preterm infants. Together, these examples illustrate that neonatal serum biomarkers reflect dynamic developmental and inflammatory processes rather than static disease states. Interpreting laboratory values within a framework integrating gestational and postnatal age enables more biologically meaningful characterization of neonatal physiological and pathological states and supports mechanism\u2010oriented research in neonatal medicine.<\/jats:p>","DOI":"10.1111\/ped.70499","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T07:57:02Z","timestamp":1785743822000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond Single Cutoffs: Gestational and Postnatal Age\u2010Specific Interpretation of Neonatal Laboratory Markers"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2871-4000","authenticated-orcid":false,"given":"Sota","family":"Iwatani","sequence":"first","affiliation":[{"name":"Department of Neonatology Hyogo Prefectural Kobe Children's Hospital Perinatal Center  Kobe Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"e_1_2_14_2_1","first-page":"1741","article-title":"Phototherapy of Neonatal Jaundice: Its Indication and Prevention of Adverse Effects","volume":"43","author":"Imura S.","year":"1985","journal-title":"Nihon Rinsho"},{"key":"e_1_2_14_3_1","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1111\/j.1442-200X.1992.tb01024.x","article-title":"Determination of Serum Unbound Bilirubin for Prediction of Kernicterus in Low Birthweight Infants","volume":"34","author":"Nakamura H.","year":"1992","journal-title":"Acta Paediatrica Japonica"},{"issue":"4","key":"e_1_2_14_4_1","doi-asserted-by":"crossref","first-page":"515.e1","DOI":"10.1016\/j.ajog.2015.11.028","article-title":"Predicting Gestational Age Using Neonatal Metabolic Markers","volume":"214","author":"Ryckman K. 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