Which neonatal reflex response would be abnormal and indicate possible neurologic injury in a neonate suspected of in utero asphyxia?

Which neonatal reflex response would be abnormal and indicate possible neurologic injury in a neonate suspected of in utero asphyxia?

• A. Toes curl downward when the soles of the feet are stroked.
• B. Grasps nurse's finger when placed in the neonate's hand.
• C. Turns toward the nurse's finger when the cheek is touched.
• D. Extends arms when the nurse claps hands.

Answer: (A)

Neonatal reflexes reveal how the nervous system is functioning and whether maturation is on track. In a baby with suspected in utero asphyxia, an abnormal reflex pattern—especially one that shows a primitive response in an unexpected way—can signal neurologic injury. Stroking the sole and seeing the toes curl downward describes a plantar response around the stimulus. In this clinical context, that particular pattern would raise concern for disrupted motor control and potential CNS injury from hypoxia. The other reflexes listed—rooting (turning toward touch on the cheek), palmar grasp (grasping a finger placed in the hand), and the Moro response (arm extension in response to a sudden stimulus)—are expected, intact reflexes in a neonate and their presence is less specific for injury in this scenario. Thus, the plantar response described is the most concerning sign and best indicates possible neurologic injury.

Neonatal reflexes reveal how the nervous system is functioning and whether maturation is on track. In a baby with suspected in utero asphyxia, an abnormal reflex pattern—especially one that shows a primitive response in an unexpected way—can signal neurologic injury.

Stroking the sole and seeing the toes curl downward describes a plantar response around the stimulus. In this clinical context, that particular pattern would raise concern for disrupted motor control and potential CNS injury from hypoxia. The other reflexes listed—rooting (turning toward touch on the cheek), palmar grasp (grasping a finger placed in the hand), and the Moro response (arm extension in response to a sudden stimulus)—are expected, intact reflexes in a neonate and their presence is less specific for injury in this scenario. Thus, the plantar response described is the most concerning sign and best indicates possible neurologic injury.