Résumé
Objective: assessment of neurodevelopmental outcome at 24 months of corrected age of very preterm infant presenting post-hemorraghic ventricular dilatation (PHVD) and analysis of epidemiological and treatment factors influencing outcome. Method: retrospective monocentric survey including children with PHVD following grade 3 or unilateral 4 intraventricular hemorrhage (IVH), born under 33 weeks of gestation and/or with birth weight under 1500 g between 2003 and 2019. Unfavorable outcome set by moderate/severe anomaly to neurological assessment et/or cerebral palsy and/or Brunet Lezine score <70. Univariate and multivariate analyzes were conducted to identify factors impacting outcome. We notably studied the need for temporizing intervention (punctures, neurosurgical temporizing procedures) and timing early or late of intervention. Results: of 108 included children, 43 survived (40%). 17 of 34 (50%) followed-up children had a normal or mildly alterated outcome, 17 (50%) had an unfavorable outcome. Children with unfavorable evolution were a majority of males (76% VS 53%, p=0.281), had a grade 4 IVH (47% VS 12%, p=0.057), did not receive complete corticosteroid cure (47% VS 82% p=0.07). Temporizing intervention rate was 23%. All children treated in a late timing had an unfavorable outcome whereas 50% of children treated early had a favorable outcome (p=0.054). In multivariate analysis, most impacting factors were unilateral grade 4 IVH (OR: 7.9 [1.2–52.5], p=0.032) and no complete prenatal corticosteroid cure (OR: 6.2 [1.1–34.6], p=0.037).Conclusion: outcome after PHVD can be favorable. Absence of grade 4 IVH and complete corticosteroid cure are the two most positive impacting factors on outcome in our survey. Our results encourage to intervene early to prevent negative effect of PHVD on children’s development.