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International audience; OBJECTIVE: To study the quality of life at school age of very preterm infants presenting isolated punctate periventricular white matter lesions (IPWL) on late-preterm or term magnetic resonance imaging (MRI). METHODS: In 1996-2000, 16 of the 131 very preterm neonates explored by MRI were found to have IPWL. At the age of 9-14, 12 children from the IPWL group were compared with 54 children born preterm but with a normal MRI (no lesion). Quality of life (Health Status Classification System Pre School questionnaire), school performance, and motor outcome were investigated. RESULTS: Overall quality of life did not differ between the groups (classified as perfect in 2/12 of the IPWL vs 20/54 in the no-lesion). The sub-items mobility and dexterity differed significantly between the two groups, with impairment in the IPWL group (p < 0.001 and p < 0.05). This group also displayed higher levels of motor impairment: they began walking later [20(4) vs. 15(3) months, p < 0.01], had higher frequencies of cerebral palsy (6/12 vs. 2/54, p < 0.05), and dyspraxia (4/12 vs. 0/54, p < 0.001). The rate of grade retention did not differ between the groups (3/12 in the IPWL group vs. 17/54 in the no-lesions group) but, as expected, was higher than that of the French general population (17.4%) during the study period. CONCLUSION: This long-term follow-up study detected no increase in the risk of subsequent cognitive impairment in very preterm infants with IPWL, but suggests that these children may have a significantly higher risk of dyspraxia, and motor impairment. © 2017 IOS Press and the authors. All rights reserved.

Au cours des dix dernieres annees, 80 a 100 % des nouveau-nes de moins de 1 500 g etaient transfuses au moins une fois pendant leurs trois premieres semaines de vie, la plupart recevant plusieurs transfusions. Afin de diminuer les risques transfusionnels, l’erythropoietine (Epo) de synthese a ete utilisee chez les nouveau-nes prematures, avec une efficacite plus importante chez les nouveau-nes de tres petit poids de naissance (PN). Trois meta-analyses recentes de la Cochrane Collaboration remettent en cause la pertinence de cette prescription. D’une part, l’efficacite de cette molecule est discutee et, d’autre part, un risque augmente de survenue de retinopathies du premature est constate. Dans cet article, nous presentons les arguments pour ou contre l’utilisation de l’Epo en neonatalogie, ses benefices et diverses indications ainsi que les alternatives possibles dans la prise en charge de l’anemie du premature.

Objectif Depuis 1999, nous avons developpe une strategie de prise en charge des nouveau-nes atteints d’une hernie congenitale de coupole diaphragmatique isolee (HCDi), basee sur une approche organisationnelle optimisee et sur un objectif de stabilisation precoce. Le but de ce travail est de decrire notre prise en charge et ses resultats avec neuf ans de recul, au sein d’une etude en population.