Neurological Status of Low-Risk Vietnamese Newborns: A Comparison with a British Newborn Cohort (Report‪)‬

INTRODUCTION A shortened and modified version of the method for the neurological assessment of full-term and premature infants, originally developed in 1981 (1), has recently been re-assessed and further developed in rural Thailand. It was shown to be reproducible when administered by local health workers (2). The test uses a proforma with drawings of stick figures to facilitate recording of findings. A series of observations and manoevures are carried out on each baby, including assessment of posture, tone, visual responsiveness, and alertness. Findings are recorded by marking the closest stick figure representation on the proforma for each item which has a score of 1 to 5 (some items do not have all scores available). A score of 3 or 4 is usually considered to be 'normal', but this depends on gestational age. Individual item scores can then be totalled. To establish whether this test can detect possible difference in neurological status, it was also applied to three groups of babies: ethnic minority Karen babies in refugee camps on the Thai-Burmese border (referred to as the Karen) and then in two maternity hospitals--one in Bangkok and the other one in London. The study has shown that the Thai and British cohorts only differed in performance on a few items. There were marked differences between the British and the Karen cohort, the latter showing poorer scores on a number of items, including those assessing visual responsiveness and truncal tone. Since the study was conducted, the original full test for the neurological examination of newborns has been updated in 1998 (3,4). The latest version of the assessment includes an 'optimality score' for individual items and for the whole examination to facilitate comparison between infants.