Sohn Min, Ahn Youngmee, Lee Sangmi
Department of Nursing, Inha University, Incheon, South Korea.
J Clin Med Res. 2011 Dec;3(6):285-90. doi: 10.4021/jocmr706w. Epub 2011 Nov 10.
Assessment of primitive reflexes is one of the earliest, simplest, and most frequently used assessment tools among health care providers for newborns and young infants. However, very few data exist for high-risk infants in this topic. Among the various primitive reflexes, this study was undertaken particularly to describe the sucking, Babinski and Moro reflexes in high-risk newborns and to explore their relationships with clinical variables.
This study is a cross-sectional descriptive study. Sixty seven high-risk newborns including full-term infants required intensive care as well as premature infants were recruited in a neonatal intensive care unit using convenient sampling method. The sucking, Babinski and Moro reflexes were assessed and classified by normal, abnormal and absence. To explore their relationships with clinical variables, birth-related variables, brain sonogram results, and behavioral state (the Anderson Behavioral State Scale, ABSS) and mental status (the Infant Coma Scale, ICS) were assessed.
The sucking reflex presented a normal response most frequently (63.5%), followed by Babinski reflex (58.7%) and Moro reflex (42.9%). Newborns who presented normal sucking and Babinski reflex responses were more likely to have older gestational age, heavier birth and current weight, higher Apgar scores, shorter length of hospitalization, better respiratory conditions, and better mental status assessed by ICS, but not with Moro reflex.
High risk newborns presented more frequent abnormal and absence responses of primitive reflex and the proportions of the responses varied by reflex. Further researches are necessary in exploring diverse aspects of primitive reflexes and revealing their clinical implication in the high-risk newborns that are unique and different to normal healthy newborns.
Primitive reflex; High risk infants; Korean; Moro reflex; Sucking reflex; Babinski reflex; The Anderson Behavioral State Scale; Infant Coma Scale.
原始反射评估是医疗保健人员对新生儿和小婴儿最早、最简单且最常用的评估工具之一。然而，关于高危婴儿在这一主题上的数据非常少。在各种原始反射中，本研究特别旨在描述高危新生儿的吸吮、巴宾斯基和莫罗反射，并探讨它们与临床变量之间的关系。
本研究为横断面描述性研究。采用方便抽样法，在一家新生儿重症监护病房招募了67名高危新生儿，包括需要重症监护的足月儿和早产儿。对吸吮、巴宾斯基和莫罗反射进行评估，并分为正常、异常和未引出三类。为了探讨它们与临床变量的关系，评估了与出生相关的变量、脑部超声检查结果、行为状态（安德森行为状态量表，ABSS）和精神状态（婴儿昏迷量表，ICS）。
吸吮反射出现正常反应的频率最高（63.5%），其次是巴宾斯基反射（58.7%）和莫罗反射（42.9%）。吸吮和巴宾斯基反射反应正常的新生儿更有可能具有较大的胎龄、较重的出生体重和当前体重、较高的阿氏评分、较短的住院时间、较好的呼吸状况以及通过ICS评估的较好精神状态，但与莫罗反射无关。
高危新生儿原始反射出现异常和未引出反应的频率更高，且反应比例因反射不同而有所差异。有必要进一步研究原始反射的各个方面，并揭示其在高危新生儿中与正常健康新生儿不同的独特临床意义。
原始反射；高危婴儿；韩国人；莫罗反射；吸吮反射；巴宾斯基反射；安德森行为状态量表；婴儿昏迷量表
