The neurological examination of non-complicated preterm newborns using the Saint-Anne Dargassies Scale from birth to term

Abstract

Objective: To describe the maturational development of 20 (aged 32-36 weeks) premature newborns (PNBs) without clinical or neurological complications from birth until term. Method: The Saint-Anne Dargassies Scale was applied every two weeks until the age of 37 weeks. Results: The PNBs showed normal Apgar and the growth in head circumference was adequate for postmentrual age. The Friedman ANOVA test found a significant difference only for the heel-to-ear angles from birth until term. The Saint-Anne Dargassies Scale detected changes in 11 PNBs and the most altered reflexes were: cardinal points, Moro, cross extension reflexe and automatic walking. These changes were found in the first 48 hours of life and in subsequent weeks until term. Conclusion: This finding alone justifies the neurological examination of PNBs, even if they show no clinical/neurological complications in the perinatal period and the importance of neuromotor assessment in preterm infants, as it enables detection and appropriate intervention. Key words: preterm newborn, Saint-Anne Dargassies Scale, neonatal neurological examination.O exame neurológico de recém-nascidos prematuros não complicados do nascimento ao termo pela escala de Saint-Anne Dargassies RESUMO Objetivo: Descrever a evolução maturacional de prematuros sem complicações clínicas ou neurológicas (RNP) do nascimento até atingir o termo. Método: A escala de SaintAnne Dargassies foi aplicada a cada duas semanas até atingir a idade de 37 semanas, considerado termo pela autora. Resultados: Os recém-nascidos prematuros apresentaram APGAR normal após a reanimação não invasiva e o crescimento do perímetro cefálico foi adequado à idade concepcional. O teste de Friedman ANOVA detectou diferenças significativas apenas para o ângulo calcanhar-orelha do nascimento ao termo. A escala de Saint-Anne Dargassies detectou 11 RNP com alterações nos reflexos: dos pontos cardinais, Moro, alargamento cruzado e o de marcha automática. Estas alterações foram encontradas nas primeiras 48 horas de vida e nas semanas subseqüentes até atingir o termo. Conclusão: Este achado por si justifica o exame neurológico de RNP mesmo que eles não apresentem complicações clínicas/neurológicas no período peri-natal, e mostra que é importante a avaliação neuromotora nos prematuros, pois isso viabiliza a detecção e intervenção adequadas. Palavras-chave: recém-nascidos prematuros, escala de Saint-Anne Dargassies, exame neurológico neonatal.

Goniometric Assessment of Muscle Tone of Preterm Infants and Impact of Gestational Age on Its Maturation in Indian Setting

“…This was in accordance with previously published studies though the timing of examination differed in these studies from the present study. [ 18 19 20 21 22 ] One study observed muscle tone assessment of preterm infants not to be influenced by birth weight, and the evolution is clearly related to PCA.…”

Interrater reliability of the Saint-Anne Dargassies Scale in assessing the neurological patterns of healthy preterm newborns

“…To assess the infants' articular angles (A), a goniometer was specially adapted, per Alves and Melo. 21 At the end of each item assessed by the SDS, the score values between 0 and 2 were estimated, where 0 was an absent response, 1 an altered response and 2 an expected response.…”