Sclerema neonatorum and joint contractures at birth as a potential complication of chronic in utero hypoxia.

Three term neonates presented with an unusual combination of skin changes (sclerema) and joint contractures at birth. In each case a prolonged period of fetal hyporeactivity was reported by the mother. Each child demonstrated a number of clinical findings consistent with chronic fetal hypoxia. Each child recovered with normal joint function. We postulate that sclerema neonatorum and joint contractures are another, though poorly recognized sequela of chronic in utero hypoxia and are preceded by a prolonged period of diminished fetal activity.