Defining the developmental exposome of the neonatal intensive care unit in preterm infants

Very preterm birth fundamentally reshapes the developmental exposome by shifting a substantial portion of gestation from the intrauterine environment to the neonatal intensive care unit (NICU), introducing a distinct constellation of nutritional, chemical, physical, and sensory exposures [ 1 ]. Advances in neonatal care have substantially improved infant survival, increasing the importance of understanding how this prolonged developmental setting may influence long-term neurodevelopmental, respiratory, and cardiometabolic health [ 2 , 3 ]. The NICU should therefore be understood not only as a restorative, lifesaving clinical environment, but also as a consequential exposomic environment during a period of rapid brain growth, organogenesis, and physiological development.