Application of a scorable neurologic examination to near-term infants: longitudinal data

The aim of this study was to follow the evolutionof neurological fi ndings in a cohort of near-terminfants born between 35 and 37 weeks. A totalof 448 infants born between 35 and 36.9 weeksgestational age with normal cranial ultrasonogramsor only minor abnormalities, were studiedusing the Hammersmith Infant NeurologicalExamination, at 6, 9 and 12 months (correctedfor prematurity). Our results showed that whilesome items such as cranial nerve and movementsshowed minimal changes over time, other itemsmainly related to “ tone ” , “ posture ” and “ refl exes ”showed progressive maturation. There was nosignifi cant difference between the infants bornat 35 and 36 weeks gestation. When comparedto term infants assessed at the same age intervals,our cohort showed a wider variability ofscores. Mean and 10 th percentile for global scoreswere lower than those reported for term infantssuggesting that when assessing infants born at35 and 36 weeks the optimality scores used forinfants born full-term should not be used as normativedata. Our results, providing longitudinaldata in near-term infants without brain lesions,can be used as a reference in both clinical andresearch setting to monitor early neurologicalsigns in those children.