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Table 4-16

CharacteristicPretermTerm
HeadOval—narrow biparietal; large in proportion to body; face looks like “old man”Square-shaped biparietal prominences; ¼ body length
Ears: form, cartilageSoft, flat, shapelessPinna firm; erect from head
Hair: texture, distributionFine, fuzzy, or wooly; clumped; appears at 20 weeksSilk; single strands apparent
Sole creasesStarting at ball of foot: ⅓ covered with creases by 36 weeks, two-third by 38 weeksEntire sole heavily creased
Breast nodules0 mm at 36 weeks; 4 mm at 37 weeks10 mm or more
NipplesNo areolaeFormed; raised above skin level
Genitalia
  • Girl
Clitoris large, labia gapingLabia larger, meet in midline
  • Boy
Small scrotum, rugae on inferior surface only, and testes undescendedScrotum pendulous, covered with rugae; testes usually descended
Skin: texture, opacityVisible abdominal veins; thin, shinyFew indistinct larger veins; thick, dry, cracked, peeling
VernixCovers body by 31–33 weeksSmall amount in creases or absent at term; postterm: dry, wrinkled
LanugoApparent at 20 weeks; by 33–36 weeks, covers shouldersMinimal or no lanugo (depends on parental ethnicity)
Muscle toneHypotonia; extension of arms and legsHypertonia; well flexed
PostureFroglikeAttitude of general flexion
Head lagHead lags; arms have little or no flexionHead follows trunk; strong arm flexion
Scarf signElbow can extend to opposite axillaElbow to midline only; infant resists
Square window90 degrees0 degrees
Ankle dorsiflexion90 degrees0 degrees
Popliteal angle180 degrees<90 degrees
Heel-to-ear maneuverTouches ear easily90 degrees
Ventral suspensionHypotonia; “rag-doll”Good caudal and cephalic tone
Reflexes
Apparent at 28 weeks; good, but no adductionComplete reflex with adduction; disappears 4 months postterm
  • Grasp
Fair at 28 weeks; arm is involved at 32 weeksStrong enough to sustain weight for a few seconds when pulled up; hand, arm, shoulder involved
Cry24 weeks: weak; 28 weeks: high-pitched; 32 weeks: goodLusty; can persist for some time
LengthUnder 47 cm (18½ inches), usually50 cm (20 inches); range: 18–22 inches
WeightUnder 2500 gm (5 lb 5 oz)3400 gm (7½ lb); range: 5 lb 8 oz–8 lb 13 oz