Chart — Neonatal
Term vs Preterm Newborn Comparison
Gestational age is written all over the newborn — skin, ears, soles, tone, and posture. This comparison covers the physical maturity findings and the complication risks that come with prematurity.
Educational use only. Formal gestational age assessment (e.g., New Ballard Score) is performed and interpreted per facility protocol. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.
Physical Maturity Findings
| Finding | Term Newborn (37–42 wk) | Preterm Newborn (under 37 wk) |
|---|---|---|
| Skin | Opaque, cracking or peeling at term | Thin, translucent, visible vessels; gelatinous if very preterm |
| Lanugo | Mostly shed — sparse patches on shoulders | Abundant fine lanugo over back and face |
| Vernix | Light, mainly in creases | Thick covering (less if extremely preterm) |
| Ear cartilage | Firm with instant recoil | Soft, slow recoil; pinna folds easily |
| Sole creases | Cover the entire sole | Faint or only anterior third |
| Breast/genitals | Raised breast bud; descended testes or covered labia minora | Flat areola; undescended testes or prominent labia minora and clitoris |
| Tone and posture | Strong flexion of all extremities | Hypotonic, extended “frog-leg” posture |
| Reflexes | Strong suck, Moro, and grasp | Weak or incomplete; suck-swallow-breathe uncoordinated before ~34 weeks |
Complication Risks of Prematurity
| System | Risk | Why |
|---|---|---|
| Respiratory | RDS, apnea of prematurity | Surfactant deficiency; immature respiratory drive |
| Thermal | Hypothermia and cold stress | Minimal brown fat and subcutaneous fat; thin skin; large surface area |
| Metabolic | Hypoglycemia | Low glycogen stores and high glucose demand |
| Neurologic | Intraventricular hemorrhage | Fragile germinal matrix vessels |
| GI | Feeding intolerance, NEC risk | Immature gut and uncoordinated feeding |
| Immune / heme | Infection, jaundice | Immature immunity; immature liver conjugation |
NCLEX Pearls
- ✦Sole creases and ear recoil are the quick visual maturity checks examiners love.
- ✦The preterm posture is extension; the term posture is flexion — tone is gestational age made visible.
- ✦Coordinated suck-swallow-breathe arrives around 32–34 weeks: before that, expect gavage feeding.
- ✦Every preterm risk traces to an immature system — link the complication to the missing maturity and the answer follows.
Related Resources
Standards & sources
Fact-checked Jun 21, 2026This page is written to align with American Academy of Pediatrics (AAP) · Neonatal Resuscitation Program (NRP) · AWHONN. It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →