Evaluation of Babinski reflex in term neonates with hypoxic ischemic encephalopathy: a cross sectional observational study

Authors

  • Somashekhar Chikkanna Department of Pediatrics, Sapthagiri Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India http://orcid.org/0000-0002-1406-3964
  • Nagaraj M. V. Department of Pediatrics, Sapthagiri Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India
  • Bhavana K. R. Department of Pediatrics, Sapthagiri Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India
  • Shwetha N. Department of Pediatrics, Sapthagiri Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20204946

Keywords:

Babinskis reflex, HIE, Sarnat and Sarnat

Abstract

Background: Assessment of primitive reflexes is one of the earliest, easiest and most frequently used method among health care workers for newborns and young infants. Babinski reflex is one of the infantile reflexes. Our aim was to study Babinski reflex in a term neonates with hypoxic ischemic encephalopathy (HIE).

Methods: This study is a cross-sectional observational study. 100 consecutive neonates fulfilling criteria of HIE according to Sarnat and Sarnat classification, admitted in our neonatal intensive care unit (NICU) were included. It was elicited from 12 hours after birth to 72 hours of birth. Babinski response was assessed using thumb nail drag method.

Results: 78% babies are term babies. 22% babies are post term babies. Male to female ratio is 1.5:1. 38% neonates belong to HIE stage I, 39% and 33% neonates belong to HIE stage II and III respectively. In HIE stage I, planter grasp was elicitable in 89%. It remain non-elicitable in 44% and 91% in HIE stages II and III respectively.

Conclusions: Absence of Babinski reflex can be correlated with the increase in severity of HIE. It is important to include the assessment of Babinski reflex along with other primitive reflexes in the newborn generally and especially in HIE.

Author Biographies

Somashekhar Chikkanna, Department of Pediatrics, Sapthagiri Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India

professor,Department pediatrics,Bangalore

Nagaraj M. V., Department of Pediatrics, Sapthagiri Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India

Department of pediatrics

References

Allen MC, Capute AJ. The evolution of primitive reflexes in extremely premature infants. Pediatr Res. 1986;20(12):1284-9.

Petrikovsky BM, Kaplan GP. Fetal grasping of the umbilical cord causing variable fetal heart rate decelerations. J Clin Ultrasound. 1993;21(9):642-4.

Sherer DM. Fetal grasping at 16 weeks’ gestation. J Ultrasound Med. 1993;12(6):316.

Jakobovits AA. Grasping activity in utero: a significant indicator of fetal behavior (The role of the grasping reflex in fetal ethology). J Perinatal Med. 2009;37(5):571-2.

Futagi Y, Tagawa T, Otani K. Primitive reflex profiles in infants: differences based on categories of neurological abnormality. Brain Dev. 1992;14(5):294-8.

Futagi Y, Suzuki Y, Goto M. Clinical significance of plantar grasp response in infants. Pediatr Neurol. 1999;20(2):111-5.

Zafeiriou DI. Plantar grasp reflex in high-risk infants during the first year of life. Pediatr Neurol. 2000;22(1):75-6.

Futagi Y, Suzuki Y. Neural mechanism and clinical significance of the plantar grasp reflex in infants. Pediatr Neurol. 2010;43(2):81-6.

Schott JM, Rossor MN. The grasp and other primitive reflexes. J Neurol Neurosurg Psychiatry. 2003;74(5):558-60.

Kurinczuk JJ, White-Koning M, Badawi N. Epidemiology of neonatal encephalopathy and hypoxic-ischaemic encephalopathy. Early Hum Dev. 2010;86(6):329-38.

Lawn JE, Lee AC, Kinney M, Sibley L, Carlo WA, Paul VK, Pattinson R, Darmstadt GL. Two million intrapartum-related stillbirths and neonatal deaths: where, why, and what can be done? Int J Gynaecol Obstet. 2009;107(1):5-18.

Horn AR, Swingler GH, Myer L, Harrison MC, Linley LL, Nelson C, Tooke L, Rhoda NR, Robertson NJ. Defining hypoxic ischemic encephalopathy in newborn infants: benchmarking in a South African population. J Perinat Med. 2013;41(2):211-7.

Futagi Y, Suzuki Y. Neural mechanism and clinical significance of the plantar grasp reflex in infants. Pediatr Neurol. 2010;43(2):81-6.

Zafeiriou DI. Plantar grasp reflex in high-risk infants during the first year of life. Pediatr Neurol. 2000;22(1):75-6.

Futagi Y, Tagawa T, Otani K. Primitive reflex profile in infants: differences based on neurological abnormality. Brain Dev.1992;14(5):294-8.

Zafeiriou DI, Tsikoulas IG, Kremenopoulos GM. Prospective follow-up of primitive reflex profiles in high-risk infants: clues to an early diagnosis of cerebral palsy. Pediatr Neurol. 1995;13(2):148-52.

Zafeiriou DI, Tsikoulas IG, Kremenopoulos GM, Kontopoulos EE. Plantar response profile of high-risk infants at one year of life. J Child Neurol. 1999;14(8):514-7.

Futagi Y, Suzuki Y, Goto M. Clinical significance of plantar grasp response in infants. Pediatr Neurol. 1999;20(2):111-5.

Downloads

Published

2020-11-24

Issue

Section

Original Research Articles