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Dubowitz Neurologic Examination in Normal Neonates.

Journal of the Korean Pediatric Society 1990;33(7):977-988.
Published online July 31, 1990.
Dubowitz Neurologic Examination in Normal Neonates.
Young Soo Lee, Soh Yeon Kim, Dong Chul Park, Kook In Park, Ran Namgung, Chul Lee, Dong Gwan Han
Department of Pediatrics, Yonsei University, College of Medicine, Seoul, Korea
정상 신생아에서 Dubowitz 신경학적 검사의 의의
이영수, 김소연, 박동철, 박국인, 남궁란, 이철, 한동관
연세대학교 의과대학 소아과학교실
Received: 6 March 1990   • Accepted: 3 April 1990
With the improvement in survival rate in high risk infants in the neonatal intensive care unit, there is rising concern about the neurologic sequelae in these infants. In order to evaluate the neur- ologic examination in normal neonates, 400 normal newborns were evaluated for a duration of 6 months from Mach 1989 to August 1989. Neonates greater than 37 weeks gestational age, birth weight greater than 2500 gm, without any evidance of perinatal complications were selected to be included in the study. The infants were examined on the 3rd postdelivery day 2 hours after feeding and the following results were obtained: 1) The male to female ratio was 1:1 with mean gestational age 39 ±1 weeks and average birth weight being 3240±380gm. 2) Among 33 items tested in the neurologic examination, 23 items were placed in columns 3 and 4, 6 items in column 2 and 4 items in column 1. 3) Significant differance (p<0.05) of 1 column between the 2 examiners were noted .in 6 items. The items were reaction to ‘rattle’ in “habituation”,‘leg recoiF and ‘popliteal angle1 in “movement and tone’’,'alerthess’,‘defensive reaction' and ‘consolability’ in “neurobehavioural items”. The above results were similar to those obtained by Dubowitz in his neurological examination and with these as a basis, any neonate with items differing by more than 2 columns from the normal variation should be regularly examined neurologically for any neurologic abnormality. These neonates should then be referred to the departments of Neurology and Rehabilitation Medicine for early management of these abnormalities in order to minimize neurologic sequlae. These examination should be included in the neurological assessment of prematures and high-risk infants so that through early detection and early management of neurologic abnormalities and quality of life can be improved at an early stage for these children.
Key Words: Dubowitz Neurological Assessment, Normal Newborns •

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