The hidden footprint of prenatal STORCH exposure: Hammersmith Infant Neurological Assessment trajectories in a longitudinal cohort across the first months after birth

Aim To examine neurological trajectories during the first months after birth in infants prenatally exposed to STORCH infections compared with controls, and to explore whether early HINE performance is associated with outcomes at 12–18 months. Methods This longitudinal cohort included 79 prenatally STORCH-exposed infants and unexposed controls [38.25 (2.38) weeks' gestation; 53.16% boys]. The HINE was administered at 3, 6, and 9 months (age corrected for prematurity). Neurodevelopmental outcomes at 12–18 months were retrieved from neuropsychological records. Linear mixed-effects models assessed HINE trajectories; logistic regression analyzed associations with atypical outcomes. Group comparisons evaluated cerebral palsy risk and suboptimality. Results HINE scores increased over time in both groups ( p < 0.001), with lower scores in the exposed group and no group-by-age interaction ( p > 0.05). The exposed group showed higher rates of suboptimal neurological performance ( p = 0.02), but no differences in scores indicating a high risk of cerebral palsy ( p > 0.41). Higher HINE scores at all time points were associated with lower odds of atypical outcome among STORCH-exposed infants, with the strongest association at 9 months. Conclusion Prenatal STORCH exposure was associated with persistently lower HINE scores despite parallel developmental trajectories. Early HINE performance was predictive of later neurodevelopmental outcomes, supporting its value as a longitudinal marker of vulnerability in this population.