Profile of fisting in term newborns

Background: Persistence of fisting of hands and cortical thumb is a predictor of abnormalities in development and dysfunction of the central nervous system, though this may be a normal finding in the immediate newborn period. Aim: To study the profile of fisting in early neonatal period. Methods: Five hundred and fifty healthy term neonates were studied. Hand position was examined by a single observer between 24-48 h of birth when the baby was awake and quiet. Complete fisting was defined as flexed fingers covering both proximal and distal palmer creases. If only the distal crease was covered, it was defined as incomplete fisting. Thumb position was observed as thumb by the side of the fingers, under the fingers and above the fingers. Results: Of the total 550 babies, 338 (61.45%) had bilateral, 39 (7.09%) had right sided and 38 (6.91%) had left sided fisting and 135 (24.55%) had open hands. Of the 1100 hands, 669 hands (60.8%) had complete and 84 (7.63%) had incomplete fisting. 'Cortical thumb' was found in 57% of fisted hands. There was no significant difference (p> 0.05) in fisting according to the sex and weight of the babies. Conclusion: Fisting was a predominant hand posture among the babies (75.45%) but cortical thumb with bilateral fisting was seen in only 30% of babies. © 2005 Published by Elsevier Ltd. on behalf of European Paediatric Neurology Society.