Skin Reflectance Changes in Kenyan Neonates during the First Month of Life: An Observational Study
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Date
2025-09
Journal Title
Journal ISSN
Volume Title
Publisher
Springer Nature
Abstract
Transcutaneous diagnostic devices are widely used in neonatal
care. The American Academy of Pediatrics (AAP) advises universal
newborn screening for hyperbilirubinemia, commonly performed
with transcutaneous bilirubin (TcB) meters.1 Both the U.S. Centers
for Disease Control and AAP recommend universal cyanotic
congenital heart disease screening using pulse oximeters.2
Although widely adopted, these transcutaneous devices have faced
renewed scrutiny regarding their diagnostic accuracy in patients with
darker skin tones, driven by increasing awareness of racial and ethnic
disparities in healthcare.3 In vitro studies have demonstrated falsely
lower TcB readings with darker modeled skin tones,4 while human
population studies have, more often, demonstrated falsely elevated
TcB readings in neonates with racial identities associated with darker
skin tone.5,6 Other studies have examined biochemical development
and color development in lighter skin tone newborns.7 To our
knowledge, this is the first study to document developmental changes
in skin tone among African newborns with darker skin pigmentation.
The U.S. Food and Drug Administration (FDA) and the International
Council for Harmonization (ICH) have both emphasized the importance
of including diverse patient populations, particularly across different
skin tones, in trials assessing transcutaneous diagnostic devices.8,9
Our study can provide these future trials with foundational insights into
the optical characteristics of newborn skin correlating not only with
skin tone but also developmental age of the pediatrics patient
Description
research article
Keywords
Citation
Bokser, Seth, et al. "Skin reflectance changes in Kenyan neonates during the first month of life: an observational study." Pediatric Research (2025): 1-5.