Hammersmith Infant Neurological Examination at 3 Months in Infants at Risk for Congenital Infections: A Cohort Study
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Published on: August 25, 2014
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.
Insights
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.
Introduction:
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.
Objective:
To compare STORCH-exposed infants with non-exposed controls using the Hammersmith Infant Neurological Examination (HINE) at 3 months of age.
Methods:
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.
Results:
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.
Conclusion:
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.
