Weight Retention Predictors for Taiwanese Women at Six-Month Postpartum

台灣產後6個月婦女體重留置的預測因子

黃子庭(Tzu-Ting Huang)；戴芳台(Fong-Tai Dai)

產後體重留置 ； 孕期體重增加 ； 身體心像 ； postpartum weight retention ； gestational weight gain ； body image

The Journal of Nursing Research

15卷1期（2007 / 03 / 01）

11 - 20

英文

本研究的目的是要確認出產後六個月婦女體重留置的因素。本研究為一個描述性相關性研究設計，由系統抽樣某北部醫學中心一年內生產的婦女，總共寄出810份問卷，其中有602份(74.32%)有效問卷寄回。本研究結果呈現：研究對象之平均身體質量指數(BMI)在孕前及產後六個月各為21.5(SD=3.32)和22.48(SD=3.39)，平均體重留置是2.42公斤，體重過重和肥胖比率則由孕前的18.27%增加到產後六個月的27.57%；孕期體重增加的量、感受到身體心像的滿意度、和孕前的體重是產後體重留置的重要預測因子，共可解釋34.5%的變異量。確認出造成體重留置的因子，強調出婦女在孕期及產後的第一個六個月期間其體重管理措施的重要性，適當的措施可減少肥胖及因肥胖而造成的疾病。

The purpose of this study was to identify factors potentially associated with weight retention measured 6 months after childbirth. A descriptive correlative design was used to systematically women who had given birth at a medical center located in northern Taiwan. Questionnaires were mailed to 810 subjects and a total of 602 valid questionnaires were collected, representing a response rate of 74.32%. The results of this study included: The average body mass index (BMI) was 21.5 (SD = 3.32) at pre-pregnancy, and 22.48 (SD = 3.39) at 6 months after childbirth. Average weight retention was 2.42 kg. Overweight and obese conditions increased among subjects from 18.27% pre-pregnancy to 27.57% at 6 months after childbirth. Significant predictors of weight retention identified in this study included gestational weight gain (GWG), perceived body image satisfaction, and pre-pregnancy weight, which, together, explained 34.5% of postpartum weight retention variance. Determinant factors identified by the analysis highlight the need for bodyweight management intervention during pregnancy as well as through the first 6-month postpartum as a way to reduce obesity and the incidence of obesity-related diseases.

1. Abrams, B.,Selvim, S.,Gunderson, E. P.(2000).Pregnancy weight gain: Still controversial.American Journal of Clinical Nutrition,71,1233-1241.
2. Beck, A. T.,Steer, R. A.(1993).Beck depression inventory manual.San Antonio, TX:The Psychological Corporation.
3. Becker, H.,Stuifbergen, A.,Oh, H. S.,Hall, S.(1993).The self-rated abilities for health practices scale: A health self-efficacy measure.Health Value,17(5),42-50.
4. Brown, J. E.,Kaye, S. A.,Folsom, A. R.(1992).Parityrelated weight change in women.International Journal of Obesity,16(9),627-631.
5. Carter, F. A.(2004).Postnatal home visits from healthcare professionals show promise for preventing postnatal depression.Evidence-Based Mental Health,8(4),108.
6. Chen, C. H.,Tseng, Y. F.,Wang, S. Y.,Lee, J. N.(1994).The prevalence and predictors of postpartum depression.The Journal of Nursing Research,2(3),263-270.
7. Cheskin, L. J.,Donze, L. F.(2001).Appearance vs health as motivators for weight loss.JAMA: Journal of the American Medical Association,286(17),2160.
8. Cohen, S.,Mermelstein, R.,Kamarch, T.,Hoberman, H. M.,I. G. Sarason (Eds.),B. R. Sarason (Eds.)(1985).Social support: Theory, research and application.Boston:M. Nihjoff.
9. The definition and strategies for obesity in Taiwan
10. The nutrition for pregnancy
11. Devine, C. M.,Bove, C. F.,Olson, C. M.(2000).Continuity and change in women's weight orientations and lifestyle practices through pregnancy and the postpartum period: The influence of life course trajectories and transitional events.Social Science & Medicine,50(4),567-582.
12. Engeland, A.,Bjorge, T.,Sogaard, A. J.,Tverdal, A.(2003).Body mass index in adolescence in relation to total mortality: 32-year follow-up of 227,000 Norwegian boys and girls.American Journal of Epidemiology,157(6),517-523.
13. Gore, S. A.,Brown, D. M.,West, D. S.(2003).The role of postpartum weight retention in obesity among women: A review of the evidence.Annals of Behavioral Medicine,26(2),149-159.
14. Gunderson, E. P.,Abrams, B.(2000).Epidemiology of gestational weight gain and body weight changes after pregnancy.Epidemiologic Reviews,22(2),261-275.
15. Gunderson, E. P.,Murtaugh, M. A.,Lewis, C. E.,Quesenberry, C. P.,West, D. S.,Sidney, S.(2004).Excess gains in weight and waist circumference associated with childbearing: The coronary artery risk development in young adults study (CARDIA).International Journal of Obesity & Related Metabolic Disorders: Journal of the International Association for the Study of Obesity,28(4),525-535.
16. Gunderson, E.,Abrams, B.,Selvin, S.(2001).Dose the pattern of postpartum weight change differ according to pregravid body size?.International Journal of Obesity,25(4),853-862.
17. Haiek, L. N.,Kramer, M. S.,Ciampi, A.,Tirado, R.(2001).Postpartum weight loss and infant feeding.Journal of the American Board of Family Practice,14(2),85-94.
18. Harris, H. E.,Ellison, G. T.,Clement, S.(1999).Do the psychosocial and behavioral changes that accompany motherhood influence the impact of pregnancy on longterm weight gain?.Journal of Psychosomatic Obstetrics & Gynecology,20(2),65-79.
19. Harris, H. S.,Ellison, G. T.(1997).Do the changes in energy balance that occur during pregnancy predispose parous women to obesity?.Nutrient Research Reviews,10,57-81.
20. Hinton, P. S.,Olson, C. M.(2001).Postpartum exercise and food intake: The importance of behavior-specific self-efficacy.Journal of the American Dietetic Association,101(12),1430-1436.
21. Huang, H. C.,Wang, S. Y.,Chen, C. H.(2004).Body image, maternal-fetal attachment, and choice of infant feeding method: A study in Taiwan.Birth,31(3),183-188.
22. Huang, Y. H.(1995).Unpublished doctoral dissertation, Kaohsiung Medical University.
23. Huang, Y. H.,Chiu, J. C.(1996).Assessment of the health promoting lifestyle profile on reliability and validity.The Kaohsiung Journal of Medical Sciences,12(9),529-537.
24. Institute of Medicine.(1990).Nutrition during pregnancy: Weight gain and nutrients.Washington, DC:National Academy Press.
25. Janney, C. A.,Zhang, D.,Sowers, M.(1997).Lactation and weight retention.American Journal of Clinical Nutrition,66(5),1116-1124.
26. Kac, G.,Benicio, M. H. D.,Velasquez-Melendez, G.,Valente, J. G.(2004).Nine months postpartum weight retention predictors for Brazilian women.Public Health Nutrition,7(5),621-628.
27. Kleinbaum, D. G.,Kupper, L. L.,Muller, K. E.(1998).Applied regression analysis and other multivariable methods.Belmont, CA:Duxbury Press.
28. Ko, H.,Huang, K.,Lee, Y.,Chuang, L.(1996).Beck depression inventory as a screening tool for pre and postpartum depression among Chinese women.Chinese Journal of Public Health,15(3),208-219.
29. Lovejoy, J. C.(1998).The influence of sex hormones on obesity across the female life span.Journal of Women's Health,7(10),1247-1256.
30. Lovelady, C. A.,Garner, K. E.,Moreno, K. L.,Williams, J. P.(2000).The effect of weight loss in overweight, lactating women on the growth of their infants.The New England Journal of Medicine,342(7),449-453.
31. Moran, C. F.,Holt, V. L.,Mattin, D. P.(1997).What do women want to know after childbirth?.Birth,24(1),27-34.
32. Mudde, A. N.,Kok, G.,Strecher, V. J.(1995).Self-efficacy as a predictor for the cessation of smoking: Methodological issues and implications for smoking cessation programs.Psychology and Health,10,353-367.
33. Muscati, S. K.,Graydonald, K.,Koski, K. G.(1996).Timing of weight gain during pregnancy, promoting fetal growth and minimizing maternal weight retention.International Journal of Obesity Related Metabolic Disorders,20,526-532.
34. National Task Force Prevention and Treatment of Obesity.(1994).Towards prevention of obesity: Research directions.Obesity Research,2(6),571-584.
35. Nothwehr, F.(2004).Attitudes and behaviors related to weight control in two diverse populations.Preventive Medicine,39(4),674-680.
36. Ohlin, A.,Rossner, S.(1990).Maternal body weight development after pregnancy.International Journal of Obesity,14(2),159-173.
37. Ohlin, A.,Rossner, S.(1994).Trends in eating patterns, physical activity and sociodemographic factors in relation to postpartum body weight development.The British Journal of Nutrition,71,457-470.
38. Olson, C. M.,Young, C. R.(2000).Gestational weight gain and body weight at one year postpartum.The FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology,14,529.
39. O''Toole, M. L.,Sawicki, M. A.,Artal, R.(2003).Structured diet and physical activity prevent postpartum weight retention.Journal of Women's Health,12(10),991-998.
40. Parham, E. S.,Astrom, M. F.,King, S. H.(1990).The association of pregnancy weight gain with the mother's postpartum weight.Journal of the American Dietetic Association,90(4),550-554.
41. Parker, J. D.,Abrams, B.(1993).Differences in postpartum weight retention between black and white mothers.Obstetrics and Gynecology,81(5),768-774.
42. Pender, N. J.(1996).Health promotion in nursing practice.Stamford, CT:Appleton & Lange.
43. Schauberger, C. W.,Rooney, B. L.,Brimer, L. M.(1992).Factors that influence weight loss in the puerperium.Obstetrics and Gynecology,79(3),424-429.
44. Soltani, H.,Fraser, R. B.(2000).A longitudinal study of maternal anthropometric changes in normal weight, overweight and obese women during pregnancy and postpartum.British Journal of Nutrition,84(1),95-101.
45. Somvanshi, N. P.(2002).Preventing postpartum weight retention.American Family Physician,66(3),380-383.
46. Strang, V. R.,Sullivan, P. L.(1985).Body image attitudes during pregnancy and the postpartum period.Journal of Obstetric, Gynecologic, and Neonatal Nursing,14(3),332-337.
47. Walker, L. O.(1996).Predictors of weight gain at 6 and 18 months after childbirth: A pilot study.Journal of Obstetric, Gynecologic, and Neonatal Nursing,25(1),39-48.
48. Walker, L. O.(1998).Weight-related distress in the early months after childbirth.Western Journal of Nursing Research,20(1),30-44.
49. Walker, L. O.,Sterling, B. S.,Timmerman, G. M.(2005).Retention of pregnancy-related weight in the early postpartum period: Implications for women's health services.JOGNN: Journal of Obstetric, Gynecologic, and Neonatal Nursing,34(4),418-427.
50. Walker, S. N.,Sechert, K. R.,Pender, N. J.(1987).The health-promoting lifestyle profile: Development and psychometric characteristics.Nursing Research,36(2),76-81.
51. World Health Organization.(1995).Physical status: The use and interpretation of anthropometry.WHO Technical Report Series (No. 854).