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Grasp Reflex Strength from Right and Left Hands is Associated with Ph
Stressor from the Umbilical Arterial Blood in Human Newborns: Handedness
and Sex-Related Differences
Üner Tan a; Nevin Zor b; Tuncay Kücüközkan b; Fatih Akcay c; Ramazan Yigitoglu c; Ebubekir Bakan c; Necip
Kutlu a
a
Department of Physiology, Atatürk University, Medical Faculty, Erzurum, Turkey b Department of Obstetrics,
Atatürk University, Medical Faculty, Erzurum, Turkey c Department of Biochemistry, Atatürk University,
Medical Faculty, Erzurum, Turkey

Online Publication Date: 01 October 1993

To cite this Article Tan, Üner, Zor, Nevin, Kücüközkan, Tuncay, Akcay, Fatih, Yigitoglu, Ramazan, Bakan, Ebubekir and Kutlu,
Necip(1993)'Grasp Reflex Strength from Right and Left Hands is Associated with Ph Stressor from the Umbilical Arterial Blood in
Human Newborns: Handedness and Sex-Related Differences',International Journal of Neuroscience,72:3,149 — 156
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 Intern. J . Neuroscience, 1993, Vol. 1 2 , pp. 149-156 0 1993 Gordon and Breach Science Publishers S.A.
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GRASP REFLEX STRENGTH FROM RIGHT AND

LEFT HANDS IS ASSOCIATED WITH pH
STRESSOR FROM THE UMBILICAL ARTERIAL
BLOOD IN HUMAN NEWBORNS: HANDEDNESS
AND SEX-RELATED DIFFERENCES
UNER TAN
Ataturk University, Medical Faculty, Department of Physiology, Erzurum, Turkey

NEVIN ZOR and TUNCAY KUCUKOZKAN

Atatiirk University, Medical Faculty, Department of Obstetrics, Erzurum, Turkey

FATIH AKCAY, RAMAZAN YIGITOGLU, and EBUBEKIR BAKAN

Downloaded By: [TÜBTAK EKUAL] At: 09:58 13 April 2009

Ataturk University, Medical Faculty, Department of Biochemistry, Erzurum,

Turkey

NECIP KUTLU
Ataturk University, Medical Faculty, Department of Physiology, Erzurum, Turkey

(Received November 27, 1992)

Grasp reflex and its asymmetry was studied in relation to pH of the umbilical blood in human newborns,
to examine whether the degree of acidity in fetal blood (birth stress) is associated with cerebral laterality.
Low pH values were considered as an index for birth stress. Grasp-reflex strength was found to be
directly related to pH in total sample. There were sex-related differences. Namely, this correlation was
true only for female newborns, not for males. Right minus left grasp-reflex strength linearly increased
with pH, i.e., low pH values were associated with left-hand dominance, but only in males. The grasp-
reflex asymmetry was not related to pH in females. It was concluded that blood pH may be associated
with motor asymmetry and motor development in human newborns, but show sex-related differences;
female brain seemed to be more sensitive to pH changes than male brain. The results partly supported
the Bakan’s hypothesis that birth stress may be associated with left-handedness.

Keywords: grasp reflex, cerebral luteralization, handedness, blood p H , human newborn

Left-handedness was considered as a pathological handedness trait. Accordingly, Bakan

and his associates (Bakan, 1971, 1975, 1977, 1978; Bakan, Dibb, & Reed, 1973)
have claimed that left-handedness may be related to birth stress, such as left hemi-
sphere anoxia. In support of their hypothesis, these authors have found that the in-
cidence of left-handedness is greater among children at high risk for prenatal and
perinatal birth complications relative to low-risk children. Moreover, these authors
have also claimed that birth order and handedness are interrelated among males only.
This hypothesis was not generally confirmed by subsequent studies (see Annett &
Ockwell, 1980; see also Nachshon & Denno, 1986). There is still an overall tendency

Address correspondence to Prof. Dr. Uner Tan, Director, Department of Physiology, Medical Faculty,
Ataturk University, Erzurum, Turkey.

149
 150 U. TAN et al.

to regard at least some of the left-handers as pathological left-handers, however.

These controversial opinions about the origin of left-handedness inspired us the idea
that there can be a close relationship between the degree of oxygen deficiency at
birth and the grasp-reflex strength and its asymmetric organization in the male and
female newborns. Accordingly, we have investigated the grasp-reflex strength and
its asymmetry in relation to hydrogen ion concentration in the umbilical artery blood
of human newborns. If Bakan’s hypothesis would be correct, there would be a direct
relationship between blood pH and the degree of grasp-reflex asymmetry. We have
measured pH from umbilical artery just after birth and the strength of the grasp reflex
from right and left hands within the first day after birth. We found that there was a
direct relationship between pH and grasp-reflex strength, but only in the female new-
borns. Low pH values were found to be associated with a leftward asymmetry in
grasp reflex, but only in males. Our results did not entirely support the Bakan’s
hypothesis about the pathological handedness. This hypothesis seems, however, to
be of importance to be examined in order to approach left-handedness a step further.

METHODS
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The experiments were performed in male and female newborns within the first day
after birth. Each neonate was normal on neurological examination. The grasp reflex
was measured by a newly designed device developed by one of us (U.T.). To mea-
sure the strength of the grasp reflex, a small balloon was attached to the pistonring
of an injector, which was connected to a resistance. This resistance was connected
to an ohmmeter and ammeter. The balloon was brought to contact with the palmar
surface of the neonate. As the neonate reflexly closed the fingers to grasp the bal-
loon, the resistance decreased and the increased electric current was recorded from
ammeter. This system functioned as a force transducer.
The reflex strengths of the right and left hands of each neonate were measured in
10 trials. The arithmetic means of the grasp reflexes from the right and left hands
were estimated. The mean strength of the grasp reflex was expressed in arbitrary
units.
To measure the blood pH, blood samples were taken from umbilical artery im-
mediately after birth. The arterial pH measurements were made by a blood gas an-
alyser (NOVA SP1, USA; see Adams & Cew, 1979).

RESULTS
Blood p H in the Male and Female Newborns
Figure 1 illustrates the distributions of the blood pH values in the male and female
newborns. The pH histogram for the female newborns showed a left shift relative
to the pH histogram for the male newborns. Accordingly, the mean pH was found
to be higher in the male newborns than the female newborns. The difference between
these means was found to be statistically significant ( t = 2.56, df = 39, p = .015).
The mean grasp-reflex strength from right hand was found to be 8.8 (SD = .9)
for the male newborns, and 8.4 (SD = -8) for the female newborns. The difference
did not reach the 5% significance level ( t = 1.35, df = 42, p = .18). Similarly, the
mean grasp reflex strength from the left hand in the male newborns (8.8; SD = .9)
was found to be slightly higher than that in the female newborns (8.4; SD = .8),
but the difference between these values did not reach the 5% significance level ( t =
1.29, df = 42, p = .20).
 GRASP REFLEX AND BLOOD pH IN NEWBORNS 151

HISTORAMS OF pH WLUES FOR THE

MALE AND FEMALE FETAL BLOOD

REL. FREQUENCY

0.7
/
MALES

0.0

0.5

0.4
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0.3

0.2

0.1

0
/4
I
7.23 7.33 7.43 7.63 7.63

PH
FIGURE I Distribution of blood pH in male and female newborns Abscissa: pH Ordinate; relative
frequency of newborns.

Blood pH and Grasp Reflex from Right and Left Hands

Total sample. Figure 2 illustrates the relationships between the grasp-reflex strength
from the rigth (A) and left (B) hands (ordinate) and umbilical blood pH (abscissa)
in the total sample. There was a positive linear correlation between the grasp-reflex
strength from right hand and blood pH. This correlation was found to be statistically
highly significant, ( r = .56, t = 3.67, df = 31, p = .001) (see Figure 2A). The
grasp-reflex strength from left hand also showed a positive linear correlation with
blood pH, which was found to be also statistically highly significant (r = .47, t =
2.99, df = 32, p = .005) (see Figure 2B).

Male newborns. Figure 3A and 3C illustrates the relationships between the grasp-
reflex strengths from right and left hands (ordinate) and umbilical blood pH (ab-
scissa) in the male newborns. There was a positive linear correlation between the
grasp-reflex strength from right hand and blood pH in the male newborns, but this
correlation did not reach the 5% significance level ( r = .38, t = 1.65, df = 17, p
 152 U. TAN et al.

A . REFLEX STRENGTH FORH RIGHT

HCtND us pH I N TOTAL SAMPLE

7.3 7.39 7.48

PH
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B. REFLEX STRENGTH FROM LEFT

HCIND us pH (TDTAL SAHPLEI

7.3 7.39 7.48

PH
FIGURE 2 Relationship between grasp-reflex strength from right (A) and left (B) hand and pH in the
total sample Abscissa: pH Ordinate: grasp-reflex strength. In A, y = -87.3 + 1 2 . 9 9 ~in
; B, y = -77.7
+ 11.7~.

= .12) (see Figure 3A). There was also no significant correlation between blood pH
and grasp-reflex strength from left hand in these male newborns ( r = .25, t = 1.08,
df = 18, p = .30) (see Figure 3C).

Female newborns. Figure 3B and 3D illustrates the relationships between the grasp-
reflex strengths from right and left hands (ordinate) and umbilical blood pH (ab-
scissa) in the female newborns. The grasp-reflex from right hand showed a highly
significant correlation with the umbilical blood pH in these female newborns (r =
.84, t = 5.39, df = 13, p = .OOO) (see Figure 3B). There was also a highly sig-
nificant correlation between pH and grasp-reflex strength from the left hand in these
subjects ( r = .80,I = 4.69, df = 13, p = .OOl) (see Figure 3D).
 GRASP REFLEX AND BLOOD pH IN NEWBORNS 153

A . REFLEX STRENGTH FROH RIGHT HAND C. REFLEX STRENGTH FRO! LEFT

u s p H I N MftLES HAND us pH I N RALES
12 C ' 7
E
CJ
'

b 10
5!03
X 8
w
el
c*
w
K 6
7.3 7.39 7 -48 7.3 7.39 7.48
PH PH

B . REFLEX STRENGTH FROM RIGHT D . REFLEX STRENGTH FROM LEFT

HAND u s pH I N FEMALES HAND us pH I N FERALES
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731 736 741 731 736 741

PH (X 0.011 PH ( X 0.01)

FIGURE 3 Relationships between grasp-reflex strength and blood pH in the male (A and C) and female
(B and D) newborns Abscissa: pH Ordinate: grasp-reflex strength. A: grasp reflex from right hand vs
pH in males ( y = -52.5 + 8 . 3 ~ ) ;B: grasp reflex from right hand vs pH in females ( y = -184 +
26. Ix); C: grasp reflex from left hand vs pH in males ( y = -36 + 6. Ix); D: grasp reflex from left
hand vs pH in females ( y = -168 + 24x).

Relation of Right Minus Left Grasp-Reflex Strength to pH

Total sample. Figure 4A illustrates the relationship between the right minus left
(R-L) grasp-reflex strength and the umbilical blood pH in the total sample. The R-
L grasp-reflex strength showed a positive linear correlation with blood pH from um-
bilical artery. This correlation was found to be statistically significant ( r = .46, t =
2.78, df = 30, p = .009) (see Figure 4A).

Male newborns. Figure 4B illustrates the relationship between the R-L grasp-reflex
strength (ordinate) and umbilical blood pH (abscissa) in the male newborns. There
was a positive linear correlation between these parameters in these newborns, which
was found to be statistically significant ( r = .54,t = 2.49, df = 16, p = .025) (see
Figure 4B).
 154 U. TAN e t a ! .

A. R-L REFLEX US pH IN TOTAL

P;

I
pE -0 .4
..-

7.3 7.39 7 -48

PH

B. R-L REFLEX US pH IN MALES

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7.3 7.39 7.48

PH

5. R-L REF. STRENGTH us pH I N FEHALES

is
fi 0.8
;8.4 ...........:

$ 0
W
- - - ’.. ...... .-.
-0.4 .a.

I4 730
a
FIGURE 4 Relationships between R-L grasp-reflex strength and blood pH Abscissa: pH Ordinate R-
; male newborns ( y = -20.3 + 2 . 8 ~ ) ;
L grasp-reflex strength. A: total sample ( y = -17.3 + 2 . 4 ~ ) B:
C: female newborns ( y = -16.2 + 2 . 2 ~ ) .

Female newborns. Figure 4C illustrates the relationship between the umbilical blood
pH (abscissa) and the R-L grasp-reflex strength (ordinate) in the female newborns.
There was no significant correlation between these parameters in these female new-
borns ( r = .34, t = 1.23, df = 13, p = .24) (see Figure 4C).

DISCUSSION
As mentioned above, left-handedness may reflect some form of neurological insult
resulting from pre- or perinatal stressors. The most important birth stressor may be
birth asphyxia. Therefore, we have measured pH from the umbilical blood imme-
 GRASP REFLEX AND BLOOD pH IN NEWBORNS 155

diately after birth. Low pH values were taken as an index for birth asphyxia. Indeed,
there have been numerous studies indicating that the incidence of left-handedness is
higher in stressful births (premature birth, prolonged labor, low birth weight, rH
incompatibility, breech delivery, multiple birth) than normal births (Ashton, 1982;
Badian, 1983; Bakan, 1977; Bakan et al., 1973; Coren & Porac, 1980; Coren,
Searleman, & Porac, 1982; Leviton & Kilty, 1976; Smart, Jeffery, & Richards,
1980). Searleman, Porac, and Coren (1988 cited from Coren & Halpern, 1991) have
reported in a review and meta-analysis that birth stress was associated with an ele-
vated percentage of left-handedness.
We found, in the present work, a positive linear correlation between blood pH
and grasp-reflex strength from the right and left hands in newborns within the first
day after birth, i.e., a left-ward asymmetry in grasp reflex was found to be associated
with low pH values in the total sample. This result supported the Bakan’s original
hypothesis. In this work, low pH values were found to be associated with negative
R-L grasp-reflex strengths (leftward asymmetry in grasp reflex). The linear rela-
tionships we have found suggested, however, a continuum in grasp-reflex strength.
According to some authors (cf. Coren & Porac, 1980; Porac & Coren, 1981), hand-
edness may be considered as a continuum, containing not only a direction, but also
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a strength or consistency. Accordingly, Coren and Halpern (1991) noted that “the
advantage of this point of view is that it allows one to look for more subtle shifts
in handedness pattern as a function of stressors.” Our linear correlations between
grasp-reflex strength and pH are in accord with this view. Hicks, Dusek, Larsen,
Williams, and Pellegrini (1980) and Coren et al. (1982) have indeed stated that “birth
stress causes only a shift in the continuum from right- to left-sidedness, not a discrete
or abrupt change to full sinistrality.” The positive linear correlations shown in the
present work confirmed such a continuous leftward shift as a function of pH indi-
cating the degree of birth stress.
We found that there was a significant positive linear correlation between blood
pH and the grasp-reflex strength from the right and left hands in the total sample.
The correlation coefficient was found to be higher for the right hand than the left
hand, indicating that the left brain is more vulnerable to pH changes than the right
hemisphere. Bakan et al. (1973) and Bakan (1977) have claimed that left-sidedness
results from physiological trauma as the consequence of a stressful birth. On the
other hand, it was earlier reported that the left cerebral hemisphere is more subject
to damage than the right hemisphere (Bingley, 1958; Gordon, 1921; Hecaen & Aju-
riaguerra, 1964; Redlich, 1908). Because of the contralateral motor control, such
damage to the left brain would result in a decrease of right-handedness and emer-
gence of left-handedness. In accord with this view, we found that the R-L grasp-
reflex strength decreased from positive values (right sidedness) toward the negative
values (left sidedness) as the blood pH decreased linearly. Bakan (1978) has indeed
suggested that the causal factor is oxygen deficiency induced by perinatal stress.
Moreover, Schwartz ( 1988) has reported that left-handedness is associated with low
Apgar scores indicating hypoxia at birth and increased incidence of neurological
abnormality (Nelson, 1989). Liederman (1983) has also concluded in a review article
that the left hemisphere is more vulnerable to damage than the right. Tan (1990) has
also found that the right hand (left brain) is of utmost importance in determining
left-handedness.
Bakan and his associates (see Nachshon & Denno, 1986) found that birth order
and handedness are interrelated among males only. In accordance with this view,
we found that asymmetry in grasp-reflex strength was related to blood pH only in
males. Thus, blood pH may influence the asymmetric motor control in an unknown
 156 U. TAN et al.

way; there was no correlation between blood pH and grasp-reflex strength in males.
On the other hand, the female brain was found to be more vulnerable to acidity of
the blood than the male brain, since there was no significant correlation between
blood pH and grasp-reflex strength from the right and left hands in male newborns.
The results of the present work provided the first direct evidence that low blood
pH in newborns is associated with a decrease in right-sided motor control especially
from left brain. A stressful birth with low pH may indeed change the motor design
of the brain. These changes were found to be associated with sex-related differences,
however, which suggest that sex hormones and even genetical factors would be the
main factors influencing the cerebral laterality .

REFERENCES

Adams, A. P., & Cew, H. (1979). Principle and Practice of Blood Gas Analysis. London: Franklin
Scientific Projects Ltd.
Annett, M., & Ockwell, A. (1980). Birth order, birth stress and handedness. Cortex. 16, 181-188.
Ashton, G . C. (1982). Handedness: An alternative hypothesis. Behavior genetics, 12, 125-148.
Badian, N. A. (1983). Birth order, maternal age, season of birth, and handedness. Cortex, 19, 451-
Downloaded By: [TÜBTAK EKUAL] At: 09:58 13 April 2009

463.
Bakan, P. (1971). Handedness and birth order. Nature, 229, 195.
Bakan, P. (1975). Are left-handers brain damaged? New Scientist, 67, 200-202.
Bakan, P. (1977). Left-handedness and birth order revisited. Neuropsychologia, 15, 837-839.
Bakan, P. (1978). Handedness and birth order: A critical note on a critical note. Perceptual and Motor
Skills, 46, 556.
Bakan, P., Dibb, G., & Reed, P. (1973). Handedness and birth stress. Neuropsychologia, 1 1 , 363-
366.
Bingley, T. (1958). Mental symptoms in temporal lobe epilepsy and temporal lobe gliomas with ref-
erence to laterality of lesion and the relationship between handedness and brainedness. Actu Psy-
chiatrica et Neurologica Scandinavica, 33 (suppl., 120).
Coren, S., & Halpem, D. F. (1991). Left-handedness: A marker for Decreased Survival Fitness. Psy-
chological Bulletin, 109, 90-106.
Coren, S., & Porac, C. (1980). Family patterns in four dimensions of lateral preference. Behavior
Genetics, 10, 333-348.
Coren, S., Searleman, A., & Porac, C. (1982). The effects of specific birth stressors on four indexes
of lateral preference. Canadian Journal of Psychology, 36, 478-487.
Gordon, H. (1921). Left-handedness and mirror writing, especially among defective children. Bruin,
43, 313-368.
Hecaen, H., & Ajuriaguerra, J. (1964). Leff-handedness. New York: Grune & Stratton.
Hicks, R. A., Dusek, C., Larsen, F., Williams, & Pellegrini, R. J. (1980). Birth complications and the
distribution of handedness. Cortex, 16, 483-486.
Liederman, J. (1983). Mechanisms underlying instability in the development of hand preference. In G.
Young, S. J. Segalowitz, C. M. Corter, & S . E. Trehub (Eds.). Manual specialization and the
developing brain. New York: Academic Press.
Leviton, A,, & Kilty, T . (1976). Birth order and left-handedness. Archieves of Neurology, 33, 664.
Nachshon, I., & Denno, D. (1986). Birth order and lateral preferences. Cortex, 22, 567-578.
Nelson, K. B. (1988, October). Perspective on the role of perinatal asphyxia in neurologic outcome.
Paper presented at the Symposium on Perinatai Asphyxia, Toronto, Ontario, Canada.
Porac, C., & Coren, S. (1981). Lateral preferences and human behavior. New York: Springer-Verlag.
Redlich, E. (1908). Epilepsie and linkshandigkeit. Archieves of Psychiatry, 44, 59-83.
Schwartz, M. (1988). Handedness, prenatal stress and pregnancy complications. Neuropsychologia, 15,
341-344.
Smart, J. L., Jeffery, C., & Richards, B. A. (1980). A retrospective study of the relationship between
birth history and handedness at six years. Early Human Development, 5 , 79-88.
Tan, U. (1990). The left brain determines the degree of left-handedness. International Journal of Neu-
roscience, 53, 75-85.