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Updated: Aug 19, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Routine examination in the neonatal period
G D Moss1, P H Cartlidge, B D Speidel
1Paediatric Department, Southmead General Hospital, Bristol.
Objective:
To assess the value of the second neonatal examination as a medical surveillance procedure.
Design:
Prospective survey of routine neonatal examinations and the abnormalities identified during 8 March-30 June 1988.
Setting:
Maternity unit with an annual birth rate of 5700.
Subjects:
For first neonatal examination: 1795 babies born in the unit during the 115 day observation period. For second routine examination: 1747 babies (97.3%) discharged from postnatal ward.
Main Outcome Measures:
Missed abnormalities (present but not previously noted); minor abnormalities (superficial infection or trivial or transient abnormalities not requiring intervention); and important abnormalities (unlikely to have been present at first examination but requiring intervention).
Results:
An abnormality was detected in 158 (8.8%) infants on first neonatal examination. 1428 (79.6%) babies had a routine second examination, which disclosed 63 previously undetected abnormalities. Of these, seven (11%) would have been present on first examination, 49 (78%) were considered minor, and seven (11%) important--the most consequential being dislocatable hips (four infants). Thus an important finding was detected by only 0.5% of second examinations.
Conclusions:
A second thorough examination in the early neonatal period cannot be justified as a screening procedure. A repeat examination of the hips alone in the first week of life is necessary.
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