Neurological assessment in infants discharged from a neonatal intensive care unit

• Published in: European journal of paediatric neurology Vol. 17; no. 2; pp. 192 - 198
• Main Authors: Romeo, Domenico M.M, Cioni, Matteo, Palermo, Filippo, Cilauro, Salvo, Romeo, Mario G
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-03-2013
• Subjects: Age; Cohort Studies; Correlation analysis; Hammersmith infant neurological examination; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Infants; Intensive care units; Intensive Care Units, Neonatal; Neonates; Neurodevelopmental disorders; Neurologic Examination - methods; Neurological outcome; Neurology; NICU; Paralysis; Pediatrics; Prediction; Psychomotor Performance - physiology; NICU; Neurological outcome; Prediction; Hammersmith infant neurological examination
• ISSN: 1090-3798; 1532-2130
• DOI: 10.1016/j.ejpn.2012.09.006

Abstract Background Longitudinal motor assessment in infants at different neurodevelopmental risk has not been previously evaluated using structured assessments. Aim To verify if the Hammersmith Infant Neurological Examination (HINE) is a good tool to predict the neuromotor outcome in infants discharged from a level II–III Neonatal Intensive Care Unit (NICU) Methods In this cohort analysis, 1541 infants discharged from our NICU between January of 2002 and the April 2006 were enrolled and assessed using the HINE at 3, 6, 9, 12 months. At two years, these infants were further assessed, and grouped into infants with normal outcome (1150), with mild disability (321) and with cerebral palsy (70), Results Correlation analysis of Spearman showed a significant ( p  < 0.0001) and moderate ( r2  = −0.55 to −0.73) negative correlation between HINE scores (3, 6, 9, 12 months) and neurological outcome at two years. Cut-off scores for each assessment' age were provided as predictive value for cerebral palsy. Discussion This study mainly showed that HINE, as soon as the first months of life, helps in the process of prediction of neurological outcome at two years of age in a heterogeneous population of infants discharged from an NICU.