Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Pediatrics, Postgraduation Program, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
BMJ Health Care Inform. 2021 Dec;28(1). doi: 10.1136/bmjhci-2021-100476.
The structural maturation of the skin is considered a potential marker of pregnancy dating. This study investigated the correlation between the morphometrical skin characteristics with the pregnancy chronology to propose models for predicting gestational age.
A cross-sectional analysis selected 35 corpses of newborns. The biopsy was performed up to 48 hours after death in the periumbilical abdomen, palm and sole regions. Pregnancy chronology was based on the obstetric ultrasound before 14 weeks. The dimensions of the skin layers, area of glands and connective fibrous tissue were measured with imaging software support. Univariate and multivariate regression models on morphometric values were used to predict gestational age.
Gestational age at birth ranged from 20.3 to 41.2 weeks. Seventy-one skin specimens resulted in the analysis of 1183 digital histological images. The correlation between skin thickness and gestational age was positive and strong in both regions of the body. The highest univariate correlation between gestational age and skin thickness was using the epidermal layer dimensions, in palm (r=0.867, p<0.001). The multivariate modelling with the thickness of the abdominal epidermis, the dermis and the area of the sebaceous glands adjusted had the highest correlation with gestational age (r=0.99, p<0.001).
The thickness of the protective epidermal barrier is, in itself, a potential marker of pregnancy dating. However, sets of values obtained from skin morphometry enhanced the estimation of the gestational age. Such findings may support non-invasive image approaches to estimate pregnancy dating with various clinical applications.
皮肤的结构成熟被认为是妊娠日期的潜在标志物。本研究调查了皮肤形态特征与妊娠时间的相关性，旨在提出预测胎龄的模型。
一项横断面分析选择了 35 例新生儿尸体。在死亡后 48 小时内，在脐周腹部、手掌和足底进行活检。妊娠时间根据 14 周前的产科超声确定。使用成像软件支持测量皮肤各层的尺寸、腺体和结缔组织纤维的面积。使用单变量和多变量回归模型对形态计量值进行分析，以预测胎龄。
出生时的胎龄范围为 20.3 至 41.2 周。71 个皮肤标本用于分析 1183 个数字组织学图像。皮肤厚度与胎龄之间在身体的两个区域均呈正相关且较强。手掌表皮层厚度与胎龄的相关性最高（r=0.867，p<0.001）。腹部表皮、真皮和皮脂腺面积调整后的表皮厚度多元建模与胎龄相关性最高（r=0.99，p<0.001）。
保护性表皮屏障的厚度本身就是妊娠日期的潜在标志物。然而，从皮肤形态计量学获得的一组值提高了对胎龄的估计。这些发现可能支持非侵入性的图像方法来估计具有各种临床应用的妊娠日期。
