Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Pediatric Neurology Unit, Università Cattolica del Sacro Cuore Roma, Rome, Italy.
Dev Med Child Neurol. 2022 Jul;64(7):871-880. doi: 10.1111/dmcn.15191. Epub 2022 Feb 24.
We explored the ability of the Hammersmith Infant Neurological Examination (HINE) to identify cognitive performance delay at 2 years in a large cohort of infants born at term.
We conducted a retrospective study of infants born at term at risk of neurodevelopmental impairments assessed using the HINE between 3 and 12 months post-term age and compared them with a cohort of typically developing infants born at term. All infants performed a neurodevelopmental assessment at 2 years of age using the Mental Development Index (MDI) of the Bayley Scales of Infant Development, Second Edition; the presence of cerebral palsy (CP) was also reported. The infants were classified as being cognitively normal/mildly delayed or significantly delayed (MDI < 70). The predictive validity of HINE scores for significantly delayed cognitive performance, in infants with and without CP, was calculated using specific cut-off scores according to age at assessment.
A total of 446 at-risk and 235 typically developing infants (345 males, 336 females; mean [SD] gestational age 38.7 weeks [1.4], range 37-43 weeks) were included. Of the at-risk infants, 408 did not have CP at 2 years; 243 had a normal/mild delayed MDI and 165 had an MDI less than 70. Of the at-risk infants, 38 developed CP. HINE scores showed a good sensitivity and specificity, mainly after 3 months, for identifying significantly delayed cognitive performance in infants without CP. In those with CP, the score was associated with their cognitive performance. The comparison group had the highest HINE scores.
The HINE provides evidence about the risk of delayed cognitive performance at age 2 years in infants born at term with and without CP.
我们旨在探讨哈默史密斯婴儿神经检查（Hammersmith Infant Neurological Examination，HINE）在足月出生的大样本队列中识别 2 岁时认知表现延迟的能力。
我们对 3 至 12 个月龄时接受 HINE 检查且存在神经发育障碍风险的足月出生婴儿进行了回顾性研究，并将其与足月出生的典型发育队列进行了比较。所有婴儿在 2 岁时均采用贝利婴幼儿发展量表第二版的心理发育指数（Mental Development Index，MDI）进行神经发育评估；还报告了脑瘫（Cerebral Palsy，CP）的存在情况。根据评估时的年龄，将婴儿分为认知正常/轻度延迟或显著延迟（MDI<70）。使用特定的截断值根据评估时的年龄计算 HINE 评分对有和无 CP 的婴儿显著认知表现延迟的预测效力。
共纳入 446 名高危婴儿和 235 名典型发育婴儿（345 名男性，336 名女性；平均[标准差]胎龄为 38.7 周[1.4]，范围 37-43 周）。高危婴儿中，408 例在 2 岁时无 CP；243 例 MDI 为正常/轻度延迟，165 例 MDI<70。高危婴儿中，38 例发展为 CP。HINE 评分在 3 个月后对无 CP 的婴儿识别显著认知表现延迟具有较好的敏感性和特异性。在有 CP 的婴儿中，评分与他们的认知表现相关。对照组的 HINE 评分最高。
HINE 为评估有无 CP 的足月出生婴儿 2 岁时认知表现延迟的风险提供了证据。
