日本新生児成育医学会雑誌　第33巻　第3号　112 ～ 119頁（2021年）

日本新生児成育医学会雑誌　33(3)：588-595；2021　

受付日：2021．04．13

受理日：2021．05．31

極低出生体重児フォローアップについての保護者の意識調査

Survey on Parental Awareness of Follow-Up Care for Very-Low-Birth-Weight Infants

＊ 1 神奈川県立こども医療センター　新生児科，＊ 2 国立成育医療研究センター研究所　小児慢性特定疾病情報室

＊ 1 Depertment of Neonatology, Kanagawa Children’s Medical Center，＊ 2 Division of Information Center for Specific Pediatric Chronic Diseases, the Research Institute, National Center for Child Health and Development

野口聡子＊ 1・豊島勝昭＊ 1・盛一享德＊ 1 ＊ 2・斎藤朋子＊ 1・下風朋章＊ 1・柴崎　淳＊ 1・星野陸夫＊ 1・川滝元良＊ 1・大山牧子＊ 1・猪谷泰史＊ 1

Satoko NOGUCHI ＊ 1，Katsuaki TOYOSHIMA ＊ 1，Akinori MORIICHI ＊ 1 ＊ 2，Tomoko SAITO ＊ 1， Tomoaki SHIMOKAZE ＊ 1，Jun SHIBASAKI ＊ 1，Rikuo HOSHINO ＊ 1，Motoyoshi KAWATAKI ＊ 1， Makiko OHYAMA ＊ 1，Yasufumi ITANI ＊ 1

Key Words：very low birth weight infants，follow-up，school-age

極低出生体重児における学童期以降のフォローアップ（フォロー）に対する保護者の認識や要望を明らかにすることを目的にアンケート調査を行った。調査時小学校4 年以上の児を対象とし，保護者109 名の回答を得た。小学校3 年（9 歳）を過ぎてフォロー外来の受診を継続していたのは全体の60％であったが，77％が10 歳以降までのフォロー継続が望ましいと回答した。9 歳またはそれ以前にフォローを終了した保護者の半数は，実際の終了年齢より長いフォローを望ましいと回答した。1,000g 未満の保護者では85％が10 歳以降のフォローを望ましいと回答し，1,000 ～ 1,499g の保護者（62％）と比較して有意に多かった（p＝0.008）。保護者のおよそ半数が児の友人関係や学習に困難があると感じており，心理・情緒の発達や学習に関する情報や支援を望んでいた。フォロー外来の終了は症例に応じて慎重に判断する必要があり，フォローの過程での適切な情報提供や具体的な支援方法の検討が今後の課題である。

In Japan, the follow-up rate for very-low-birth-weight（VLBW）infants is reported to be 61.8％ at three years of age. To continue follow-up care, it is important to identify parental needs. The purpose of this study was to assess parental awareness of follow-up care for school-age children（age 10 ～ 15 years） born in our institution. We conducted a questionnaire survey of parents of children born with VLBW. Of the 109 survey participants, 72 were born with extremely-lowbirth- weight（ELBW） and 37 were born with VLBW. A total of 77％ of parents considered it desirable to continue followup care after the age of 9 years, but only 60％ of parents actually continued. About half of the parents who completed follow-up care until the age of 9 years or earlier stated that longer follow-up care was preferred, especially parents of ELBW children compared to parents of VLBW children（p＝0.009）. A total of 82％ of children attended regular classes in elementary schools, but half of the parents were concerned about their children’s social problems and learning difficulties. It is important to inform parents about the psycho-emotional developmental problems in later childhood and support them appropriately. Careful determination of the age patients should be at end of follow-up must be made on a case-bycase basis. Follow-up should be continued until at least the age of 9 years to assess and support children for better social and educational development.