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 show how well the nervous system pathways are functioning at birth. In a baby suspected of in utero asphyxia, you’re looking for signs of intact versus injured CNS. The plantar (toe-curl) response to stroking the sole is a basic reflex that normally appears as toes curling downward. However, when brain injury from hypoxia-ischemia has occurred, the corticospinal tract can become irritated or damaged, and an abnormal pattern—most famously a Babinski-type response with toe extension and spreading—would be expected rather than a simple downward curl. So, in this scenario, the described plantar flexion (toes curling downward) would be considered an abnormal finding because it does not reflect the expected corticospinal response signaling potential neurologic injury. The other responses listed—rooting toward a cheek touch, grasping a finger, and the Moro response to a sudden stimulus—are typical neonatal reflexes that indicate intact brainstem and sensorimotor pathways when present and symmetrical.