Hammersmith Infant Neurological Examination at 3 Months in Infants at Risk for Congenital Infections: A Cohort Study

TL;DR

This study shows that infants exposed to STORCH infections in the womb have neurological impairments detectable at 3 months, as measured by the HINE.

Contribution

The study introduces the use of the HINE at 3 months to detect early neurological risks in STORCH-exposed infants.

Findings

Exposed infants had lower HINE global scores and subscores compared to controls.

Exposed infants showed more asymmetries and a higher risk of cerebral palsy.

Neurological impairments were detectable in STORCH-exposed infants as early as 3 months.

Abstract

STORCH refers to a group of congenital infections (syphilis, toxoplasmosis, rubella, cytomegalovirus and herpes) that can impact the central nervous system. As clinical signs may not appear until several months or years after birth, the early detection of risk in STORCH‐exposed infants has been challenging, and the use of sensitive tools in this population is understudied.

To compare STORCH‐exposed infants with non‐exposed controls using the Hammersmith Infant Neurological Examination (HINE) at 3 months of age.

This is an observational cohort study. A total of 60 infants were included and equally allocated into two groups: an exposed group, whose mothers had a clinically confirmed diagnosis of a classic STORCH infection during pregnancy, and a non‐exposed control group, whose mothers did not present STORCH infections during gestation. At 3 months of age (13.83 ± 1.09 weeks post‐term), infants were assessed using the HINE. Group comparisons were performed for the global score, subscores across the five scorable domains (cranial nerve function, posture, spontaneous movements, tone and reflexes and reactions), number of asymmetries and risk of cerebral palsy.

The exposed group showed lower global scores and lower subscores in most HINE domains compared to controls, along with a higher frequency of asymmetries and an increased proportion of infants classified as at high risk for cerebral palsy.

Infants prenatally exposed to STORCH infections showed an increased risk of impairment based on the HINE when compared to controls. Potential neurological limitations were detectable in the exposed group at 3 months of age.

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