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Predictive ability of the Hammersmith Neonatal Neurological Examination for identifying severe neurodevelopmental impairment in infants born very preterm.

Created on 04 Jul 2026

Authors

Jiarui Liu, Vijayendra Ranjan Baral, Imelda Lustestica Ereno, Kelly Ann Zainal, Jaslyn Ong, Jing Shi Chua, Joo Guan Yeo, Cheo Lian Yeo

Published in

Developmental medicine and child neurology. Jul 03, 2026. Epub Jul 03, 2026.

Abstract

To evaluate the predictive ability of the Hammersmith Neonatal Neurological Examination (HNNE) at term-corrected age (TCA) for severe neurodevelopmental impairments at 2 years corrected age in infants born very preterm.
This retrospective study evaluated 88 infants, born at less than 29 weeks' gestation or weighing less than 1250 g using the HNNE at TCA (37 + 0 to 41 + 6 weeks). Neurodevelopmental outcomes at 2 years corrected age were determined using the Bayley Scales of Infant and Toddler Development. The diagnostic accuracy of the HNNE was assessed according to its ability to predict severe motor (< 74.5), cognitive, and language (< 71.2) impairments.
The HNNE demonstrated moderate diagnostic performance for severe motor impairment (sensitivity = 75.0%, specificity = 64.5%, area under the curve [AUC] = 0.80), with lower scores associated with poorer outcomes (median = 20.3; p = 0.04). Performance was weaker for cognitive (sensitivity = 66.7%, specificity = 61.9%, AUC = 0.73) and language (sensitivity = 44.4%, specificity = 63.0%, AUC = 0.62) outcomes. High negative predictive values (NPV) across all domains (NPV = 98.0%, 98.1%, 90.2%) indicated low risk of impairment with optimal scores.
The HNNE is a reliable early screening tool for severe motor and cognitive impairment at 2 years corrected age in infants born very preterm. Future studies should examine individual HNNE subscales and their integration with complementary tools to improve comprehensive neurodevelopmental risk stratification.

PMID:
42400163
Bibliographic data and abstract were imported from PubMed on 04 Jul 2026.

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