بررسی حفظ وزن بعد از زایمان و ارتباط آن با وضعیت عملکرد مادری 6 ماه پس از زایمان

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دانشجوی کارشناسی ارشد مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

2 استادیار گروه بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

3 دانشیار گروه بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

4 مربی گروه مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

5 استاد گروه اپیدمیولوژی، دانشکده پزشکی، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

چکیده

مقدمه: بارداری و زایمان با تغییراتی در وزن و وضعیت عملکرد مادری همراه است. با توجه به نتایج به دست آمده از پژوهش­ها مبنی بر کاهش فعالیت عملکردی در افراد چاق، مطالعه حاضر با هدف تعیین حفظ وزن و ارتباط آن با وضعیت عملکرد مادری در 6 ماه پس از زایمان انجام شد.
روش‌کار: این مطالعه مقطعی در سال 1395 بر روی 307 زن زایمان کرده در شهر اردبیل انجام گرفت. حفظ وزن به صورت تفاضل وزن ثبت شده در هفته 12-10 بارداری و وزن ثبت شده در 6 ماه پس از زایمان تعریف شد. ابزار گردآوری داده­ها شامل پرسشنامه مشخصات فردی اجتماعی و پرسشنامه وضعیت عملکرد پس از زایمان بود. تجزیه و تحلیل داده­ها با استفاده از نرم‌افزار آماری SPSS (نسخه 17) و آزمون‌های همبستگی پیرسون، مدل رگرسیون لوجستیک و مدل خطی عمومی با تعدیل متغیرهای پایه انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته‌ها: میانگین حفظ وزن زنان 6 ماه بعد از زایمان 5/0±99/9 کیلوگرم بود. بر اساس نتایج آزمون همبستگی پیرسون، بین تمام زیر دامنه­ها شامل مسئولیت خانه (05/0=p)، فعالیت اجتماعی (042/0=p)، مراقبت از نوزاد (009/0=p) و مراقبت از خود (001/0>p) با حفظ وزن ارتباط معنی‌داری وجود داشت. تنها زیر دامنه‌ای از وضعیت عملکردی که با حفظ وزن ارتباط معنادار نداشت، زیر دامنه شغل بود (05/0<p).
نتیجه‌گیری: زنان حفظ وزن قابل قبولی 6 ماه بعد از زایمان داشتند و حفظ وزن بالا با وضعیت عملکردی مادری پایین همراه بود، بنابراین نیاز به ارزیابی دقیق‌تر وزن مادران پس از زایمان و توصیه­های مناسب تغذیه در دوران شیردهی می­باشد.

کلیدواژه‌ها

عنوان مقاله [English]

Assessment of postpartum weight maintenance and its association with maternal functional status during 6 months after childbirth

نویسندگان [English]

  • Elham Ghobadi Jamadi 1
  • Sevil Hakimi 2
  • Mojgan Mirghafourvand 3
  • Simin Seidi 4
  • Saeed Dastgiri 5
1 M.Sc. student of Midwifery, School of Nursing & Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
2 Assistant Professor, Department of Reproductive Health, School of Nursing & Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
3 Associate Professor, Department of Reproductive Health, School of Nursing & Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
4 Instructor, Department of Midwifery, School of Nursing & Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
5 Professor, Department of Epidemiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
چکیده [English]

Introduction: Childbirth causes increasing weight between 0.4 to 1.8 kg according woman's age. Changes in life as a result of pregnancy and childbirth result in shifting in mothers operations and some can't handle taking care of their infant even in third month and don’t start housework and social activities. According to the results of researches about activity subtraction of fat people, aim of this study is to consider weight retentionand its relation with mothers' functional state in 6 months after childbirth.
Methods: This cross sectional research has been done 6 months after delivery on 307 in Ardabil, 2016. Weight retention was measured by minus weight in 10th-12th week of pregnancy and weight in 6 month after childbirth. Weighting process was done by a similar person in each time. Data gathering tools in this research were included socio demographic and functional status questionnaire.
Results: three hundred seven women participated in this study from May to August 2016. The mean (SD) Body Mass Index was 25.58(4.47). The mean (SD) weight retention 6 months after delivery was 0.5(9.99) kg. Out of job subdomain of functional status, others, including household activities (p=0.05), social and community activities (p=0.042), infant care activities (p= 0.009) and self-care activities (p<0.001) had significant correlation with weight retention.
Conclusion: Studied women had acceptable weight retention 6 months after delivery. In present study there is a significant and inverse correlation between all functional status subdomains (except job). In the way that more weight retention caused less points in each four subdomains.

کلیدواژه‌ها [English]

  • Obesity
  • weight retention
  • functional status
  • Delivery

مراجع

  1. Cunningham F, Leveno K, Bloom S, Spong CY, Dashe J. Williams obstetrics. 24th ed. New York: McGraw-Hill; 2014.
  2. Bahrami Taghanaki H, Hashemian M, Lotfalizadeh M, Noras MR. The relationship between Body Mass Index (BMI) and birth weight and some pregnancy outcomes. Iran J Obstet Gynecol Infertile 2016; 19(30):1-8. (Persian).
  3. Gunderson EP. Epidemiologic trends and maternal risk factors predicting postpartum weight retention. Obesity During Pregnancy in Clinical Practice. London: Springer; 2014. P. 77-97.
  4. Li N, Liu E, Guo J, Pan L, Li B, Wang P, et al. Maternal prepregnancy body mass index and gestational weight gain on pregnancy outcomes. PloS One 2013; 8(12):e82310.
  5. Nohr EA, Vaeth M, Baker JL, Sørensen TI, Olsen J, Rasmussen KM. Combined associations of prepregnancy body mass index and gestational weight gain with the outcome of pregnancy. Am J Clin Nutr 2008; 87(6):1750-9.
  6. Wolfe WS, Sobal J, Olson CM, Frongillo EA. Parity‐associated body weight: modification by sociodemographic and behavioral factors. Obes Res 1997; 5(2):131-41.
  7. Ehrlich SF, Hedderson MM, Feng J, Davenport ER, Gunderson EP, Ferrara A. Change in body mass index between pregnancies and the risk of gestational diabetes in a second pregnancy. Obstet Gynecol 2011; 117(6):1323-30.
  8. McLean N, Griffin S, Toney K, Hardeman W. Family involvement in weight control, weight maintenance and weight-loss interventions: a systematic review of randomised trials. Int J Obes Relat Metab Disord 2003; 27(9):987-1005.
  9. Posmontier B. Functional status outcomes in mothers with and without postpartum depression. J Midwifery Womens Health 2008; 53(4):310-8.
  10. Aquino JA, Russell DW, Cutrona CE, Altmaier EM. Employment status, social support, and life satisfaction among the elderly. J Counsel Psychol 1996; 43(4):480.
  11. Mckee MD, Cunningham M, Jankowski KR, Zayas L. Health-related functional status in pregnancy: relationship to depression and social support in a multi-ethnic population. Obstet Gynecol 2001; 97(6):988-93.
  12. Otto S, De Groot R, Hornstra G. Increased risk of postpartum depressive symptoms is associated with slower normalization after pregnancy of the functional docosahexaenoic acid status. Prostaglandins Leukot Essent Fatty Acids 2003; 69(4):237-43.
  13. Aktan NM. Functional status after childbirth a review of the literature. Clin Nurs Res 2007; 16(3):195-211.
  14. Barkin JL, Wisner KL. The role of maternal self-care in new motherhood. Midwifery 2013; 29(9):1050-5.
  15. Tulman L, Fawcett J, Groblewski L, Silverman L. Changes in functional status after childbirth. Nurs Res 1990; 39(2):70-5.
  16. Ratner PA, Johnson JL, Bottorff JL, Dahinten S, Hall W. Twelve-month follow-up of a smoking relapse prevention intervention for postpartum women. Addict Behav 2000; 25(1):81-92.
  17. Baheiraei A, Mirghafourvand M, Charandabi SM, Mohammadi E, Nedjat S. Health-promoting behaviors and social support in Iranian women of reproductive age: a sequential explanatory mixed methods study. Int J Public Health 2014; 59(3):465-73.
  18. Fawcett J, Tulman L, Myers ST. Development of the inventory of functional status after childbirth. J Nurs Midwifery 1988; 33(6):252-60.
  19. Mirghafourvand M, Mohammad-Alizadeh-Charandabi S, Jafarabadi MA, Mohammadi A, Soltanpour S. Psychometric properties of the Iranian version of the inventory of functional status after childbirth (IFSAC). Iran Red Crescent Med J 2016; In Press.
  20. World Health Organization. Global database on body mass index. Geneva: World Heart Organization; 2017.
  21. Olson CM, Strawderman MS, Hinton PS, Pearson TA. Gestational weight gain and postpartum behaviors associated with weight change from early pregnancy to 1 y postpartum. Int J Obes Relat Metab Disord 2003; 27(1):117-27.
  22. Siega-Riz AM, Herring AH, Carrier K, Evenson KR, Dole N, Deierlein A. Sociodemographic, perinatal, behavioral, and psychosocial predictors of weight retention at 3 and 12 months postpartum. Obesity 2010; 18(10):1996-2003.
  23. Kac G, Benício MH, Velásquez-Meléndez G, Valente JG, Struchiner CJ. Breastfeeding and postpartum weight retention in a cohort of Brazilian women. Am J Clin Nutr 2004; 79(3):487-93.
  24. Krause KM, Lovelady CA, Peterson BL, Chowdhury N, Østbye T. Effect of breast-feeding on weight retention at 3 and 6 months postpartum: data from the North Carolina WIC Programme. Public Health Nutr 2010; 13(12):2019-26.
  25. Baker JL, Gamborg M, Heitmann BL, Lissner L, Sørensen TI, Rasmussen KM. Breastfeeding reduces postpartum weight retention. Am J Clin Nutr 2008; 88(6):1543-51.
  26. Kac G, Benício MH, Velásquez-Meléndez G, Valente JG, Struchiner CJ. Gestational weight gain and prepregnancy weight influence postpartum weight retention in a cohort of Brazilian women. J Nutr 2004; 134(3):661-6.
  27. Fanuele JC, Abdu WA, Hanscom B, Weinstein JN. Association between obesity and functional status in patients with spine disease. Spine 2002; 27(3):306-12.
  28. Mckee MD, Cunningham M, Jankowski KR, Zayas L. Health-related functional status in pregnancy: relationship to depression and social support in a multi-ethnic population. Obstet Gynecol 2001; 97(6):988-93.
  29. Jensen GL, Hsiao PY. Obesity in older adults: relationship to functional limitation. Curr Opin Clin Nutr Metab Care 2010; 13(1):46-51.

Jensen GL, Friedmann JM. Obesity is associated with functional decline in community-dwelling rural older persons. J Am Geriatr Soc 2002; 50(5):918-23.

مجله زنان، مامایی و نازایی ایران
دوره 20، شماره 6
شهریور 1396
صفحه 61-68

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