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Neurological, Muscle, and Maturity Assessment of Neonates by Gestational Age

Clinical Manifestation Items Gestational Age
30-32 weeks 33-34 weeks 35-36 weeks 37-38 weeks 39-40 weeks
Forearm Recoil None None or very slow Slow Slow Rapid
Scarf Sign No resistance No resistance Slight resistance Elbow does not cross midline Obvious resistance
Angle of the Axilla 180° 160° 120° 90° <90°
Heel to Ear No resistance No resistance Slight resistance Obvious resistance Heel cannot touch ear
Support Sitting with Neck Control Weak Weak Weak Head slightly forward Head forward for a moment
Rooting Reflex Absent or weak Requires head support to strengthen Present Present Present
Crossed Extension Reflex None None or flexed leg Flexed leg Flexed-extended Flexed-extended-adducted
Embrace Reflex Absent or weak Arm extension and abduction Arm extension and abduction Arm flexion and adduction Arm flexion and adduction
Grasp Reflex Can grasp, weak Can grasp, weak Can grip tightly Can lift upper arm Can lift body
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