Babinski reflex evaluation in term neonates with hypoxic ischemic encephalopathy: A cross-sectional observational study

Background: Assessment of primitive reflexes is one of the earliest, easiest and most frequently used method among health care workers for newborns and young infants. Babinski reflex is one of the infantile reflexes. Our aim was to study Babinski reflex in a term neonates with hypoxic ischemic encephalopathy (HIE). The incidence of HIE in developed countries is estimated to be 1.5 per 1,000 live births. Estimates in developing countries range from 2.3-26.5 per 1,000 live births.
Methods: This study is a cross-sectional observational study. 70 consecutive neonates fulfilling criteria of HIE according to Sarnat and Sarnat classification, admitted in our neonatal intensive care unit (NICU) were included. It was elicited from 12 hours after birth to 72 hours of birth. Babinski response was assessed using thumb nail drag method.
Results: 83% babies are born to 18-35 years and 17% to elderly gravid. 55% are delivered through normal vaginal delivery and 45% to LSCS. 52% neonates belong to HIE stage I, 30% and 18% neonates belong to HIE stage II and III respectively. In HIE stage I, planter grasp was elicitable in 89%. It remains non-elicitable in 44% and 91% in HIE stages II and III respectively.
Conclusions: Absence of Babinski reflex can be correlated with the increase in severity of HIE. It is important to include the assessment of Babinski reflex along with other primitive reflexes in the newborn generally and especially in HIE.