The prognostic implications of neurologic abnormalities in the neonatal period

Abstract
Among 2,100 unselected ward deliveries at the Boston Lying-in Hospital, 192 full-term infants received a double neurologic examination at approximately 72 hours of age. Approximately half of the group were thought abnormal on the initial examination. The others represented controls undesignated to the second examiner. There was relatively poor correlation between the opinions of the two examiners as to over-all normality or abnormality. Seventy-eight of 80 infants thought normal by both examiners in the newborn period were also normal by the criteria applicable at age 1 year. Approximately 80% of those thought abnormal by one or both neonatal examiners were also normal at one year. The conventional neurologic signs and infantile postural automatisms applicable in the newborn period all seemed individually and in combination of only very limited predictive value as to the likelihood of abnormality at one year. The single most ominous combination was that of depression of automatisms, particularly the traction response and Moro reflex, with exaggerated tremulousness.