Abstract
To study the association between the Hammersmith Infant Neurological Examination (HINE) at age 2years and neurocognition at age 11years in children born very preterm. We hypothesized that the HINE at 2years would be associated with neurocognition, that is, neurological, motor, and cognitive outcomes at 11years. A total of 174 children (mean gestational age 29.0wks, SD 2.7; minimum 23.0, maximum 35.9; 95 [55%] males, 79 [45%] females) born very preterm (birthweight ≤1500g/gestational age <32wks), were included in a prospective cohort recruited from 2001 to 2006 in Turku, Finland. The HINE was performed at 2years' corrected age. Neurocognition at 11years was assessed with the Touwen neurological examination, Movement Assessment Battery for Children, Second Edition (MABC-2), and full-scale IQ (Wechsler Intelligence Scale for Children, Fourth Edition). The HINE global score was associated with the results of the Touwen neurological examination (odds ratio [OR]=0.9, 95% confidence interval [CI] 0.8-0.9, p=0.001), MABC-2 (β=1.4, 95% CI 0.7-2.2, p<0.001), and full-scale IQ (β=1.2, 95% CI 0.8-1.7, p<0.001), even when adjusted. When children with cerebral palsy (CP) were excluded, the HINE was still associated with full-scale IQ (unadjusted β=1.2, 95% CI 0.3-2.1, p=0.01). A higher HINE global score at 2 years was associated with better general intelligence at 11 years even in children without CP. The HINE may be a useful tool to detect children at risk for later cognitive impairment. What this paper adds A Hammersmith Infant Neurological Examination (HINE) global score at 2years was associated with long-term neurocognitive function. Severe cognitive impairment was significantly more common in 11-year-old children with complex minor neurological dysfunction compared to typically developing children. The HINE performed at 2years detects risks of cognitive impairment at 11years in children born very preterm. A higher HINE score at 2years was associated with better general intelligence at 11years.
Highlights
INTERPRETATION A higher Hammersmith Infant Neurological Examination (HINE) global score at 2 years was associated with better general intelligence at 11 years even in children without cerebral palsy (CP)
When the HINE global score increased by 1 point, the subsequent full-scale IQ was improved by 1.2 points
A higher HINE global score at 2 years was associated with better general intelligence, verbal comprehension, perceptual reasoning, and processing speed at 11 years even when adjusted for sex, brain magnetic resonance imaging (MRI) findings at term, paternal education, and birthweight z-score
Summary
Our aim was to study the association between the HINE at 2 years’ corrected age and neurocognition, that is, neurological, motor, and cognitive outcomes at 11 years in children born very preterm
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