Hammersmith Infant Neurological Examination: Prediction of neurodevelopmental delay in children born between 29 and 36 weeks of gestation

Abstract Aim To evaluate the ability of the Hammersmith Infant Neurological Examination (HINE) at 3 months 2 weeks corrected age to identify developmental difficulties at 2 years corrected age in infants born preterm between 29 and 36 weeks of gestation. Method In this prospective cohort study, the HINE was administered at 3 months 2 weeks corrected age. Development was assessed at 2 years corrected age using the Bayley Scales of Infant and Toddler Development, Fourth Edition (Bayley‐4) and MacArthur–Bates Communicative Development Inventories. Developmental delay was defined using Bayley‐4 scores less than 1 SD below the mean; expressive language delay was defined as a score less than the 10th centile for the number of spoken words expected for age. The cohort was largely free of brain lesions typically associated with cerebral palsy (5% intraventricular hemorrhage, with no other major brain lesions reported). Associations were examined using linear regression, screening performance using receiver operating characteristic curves, and incremental predictive value by comparing adjusted R 2 across models, including perinatal and socioenvironmental factors with and without the HINE. Results A total of 174 infants were included in the analyses. The HINE total score was not associated with motor, cognitive, or language outcomes. Discriminative performance was poor (area under the curve = 0.48–0.57); adding the HINE total score to models including perinatal and socioenvironmental factors did not improve predictive performance. Interpretation A single HINE at 3 months 2 weeks corrected age has limited utility for identifying mild‐to‐moderate developmental difficulties in this population and should not be used alone to determine developmental surveillance needs. Longitudinal surveillance incorporating complementary sources of developmental, clinical, and socioenvironmental information may be more effective.