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Hammersmith Infant Neurological Examination at 3 Months in Infants at Risk for Congenital Infections: A Cohort Study
Karen Cristine Oliveira de Azambuja1, Amanda Amanda de Arguelho Oliveira Arguelho1,2, Meyene Duque Weber1,3
1Graduate Program in Movement Sciences, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil.
Journal of Paediatrics and Child Health
|January 1, 2026
Summary
Congenital STORCH infections increase infant risk for neurological impairment. The Hammersmith Infant Neurological Examination (HINE) detected higher risks in exposed infants at 3 months, aiding early detection.
Area of Science:
- Neonatal neurology
- Pediatric infectious diseases
- Developmental pediatrics
Background:
- STORCH infections (syphilis, toxoplasmosis, rubella, cytomegalovirus, herpes) pose risks to the central nervous system in infants.
- Early detection of neurological risk in STORCH-exposed infants is challenging due to delayed symptom onset.
- Sensitive neurological assessment tools for this population are understudied.
Purpose of the Study:
- To compare neurological outcomes of STORCH-exposed infants versus non-exposed controls.
- To evaluate the utility of the Hammersmith Infant Neurological Examination (HINE) at 3 months corrected age.
Main Methods:
- Observational cohort study of 60 infants (30 exposed, 30 controls).
- Mothers of exposed infants had confirmed STORCH infections during pregnancy.
- Infants assessed at 3 months corrected age using the HINE, evaluating global scores, domain subscores, asymmetries, and cerebral palsy risk.
Main Results:
- STORCH-exposed infants exhibited lower HINE global scores and domain subscores compared to controls.
- A higher frequency of neurological asymmetries was observed in the exposed group.
- Infants exposed to STORCH infections showed an increased proportion classified as high risk for cerebral palsy.
Conclusions:
- Prenatal STORCH infection exposure is associated with an increased risk of neurological impairment detectable by HINE at 3 months.
- The HINE is a sensitive tool for identifying potential neurological limitations in STORCH-exposed infants early in life.
