臺灣博碩士論文加值系統

肥胖是許多慢性疾病的重要風險因子，產後體重保留則是造成婦女肥胖的重要因素之一。目前國內針對婦女產後體重變化之相關研究並不多，嬰兒餵食方式對婦女產後飲食與體重變化相關研究更是稀少。本研究採用問卷調查及立意取樣的方式，針對產後婦女嬰兒餵食方式、飲食狀況與體重變化之間的相關性並探討影響婦女產後體重保留之因素。本研究以台北地區某教學醫院婦產科門診懷孕超過32週以上的婦女為召募對象，收案108人。研究期當中追蹤62位以哺育母乳的婦女(Breast Feeding組,簡稱BF組)與46位以嬰兒奶粉餵食的婦女(Formula Feeding組,簡稱FF組)，在婦女產後一個月、三個月、六個月進行追蹤調查。追蹤調查內容包括:(1)婦女體位測量資料(anthropology assessment):身高、體重，(2)嬰兒餵食與個人生活型態問卷，(3)飲食評估：24小時飲食回憶(24 hour dietary recall)。資料以統計軟體SPSS進行，包括描述性統計分析(descriptive statistics) 、卡方檢定(Chi-square test) 、t-檢定(student t-test) 、多變項回歸分析(Multiple regression analysis)。
研究結果顯示，懷孕期體重平均增加14.4±3.5公斤，產後六個月體重平均保留2.8±3.6公斤。不同哺育方式對產後六個月體重保留沒有顯著差異，但是在熱量及三大營養素攝取量上有顯著差異(p<0.01)。產後體重保留的相關因子以懷孕期體重增加量及嬰兒出生體重相關性最強。結論是母乳哺育組在熱量攝取明顯比嬰兒配方奶粉組多，但產後六個月體重保留量母乳哺育組比嬰兒配方奶粉組有降低的趨勢。因此鼓勵生產後的產婦母乳哺育至少六個月或更長的時間，未來類似研究應在飲食攝取量上做飲食衛教建議。

Obesity is a key contributory factor to the risk of chronic disease, and postpartum weight retention is one of the main reasons for female obesity. Limited research has been conducted to date on changes in postpartum female body weight, and even less on how baby feeding methods can affect postpartum diets and body weight changes. This research will be based on a questionnaire survey and purposive sampling, and focus on postpartum baby feeding practices, diet status and body weight change. The purpose is to examine the relevancy of this three factors, and to explore other factors causing postpartum weight retention. Research samples will be collected from one Taipei medical center for clinical expectant women over 32 weeks pregnant, and the sample size was 108. Over the next six months, this research plans to track 62 breast-feeding mothers (BF Group) and 46 formula- feeding mothers (FF Group), and to investigate their body weight status after one month, three months, six months after childbirth. The following items was tracted：(1) an anthropology assessment：height and weight,(2) baby feeding practices and personal lifestyle, (3) diet assessment：24-hour dietary recall and food frequency questionnaire. The data was analyzed by using statistical software (SPSS), including descriptive statistics, Chi-square test, student t-test, multiple regression analyses.
The results showed that the mean weight gain during pregnancy was 14.4±3.5 kg and weight retention at 6 months postpartum was 2.8±3.6 kg. There was no significant between the different type of infant feeding and weight retention at 6 months postpartum, but food intake of calorie and macro-nutrition was significant(p<0.01). Gestational weight gain and infant birth weight was the variable most highly correlated to postpartum weight retention. Conclusion is that the total energy intake was BF group significant more than FF group, but six months postpartum weight retention was reduced of BF group more than FF group. So we hope breast-feeding six months after childbirth at least or longer, but it is need to diet control of energy intake in the future.

目錄
中文摘要...…………………………………………………………………i
英文摘要.…………………………………………………………………iii
致謝..………………………………………………………………………v
目錄....……………………………………………………………………vii
表目錄……………………………………………………………………ix
圖目錄.……………………………………………………………………x
附錄表……………………………………………………………………xii
第一章 緒論………………………………………………………………1
第一節 背景……………………………………………………………1
第二節 目的……………………………………………………………3
第二章 文獻回顧…………………………………………………………4
第一節 影響產後婦女體重變化之因素………………………………4
第二節 影響產後婦女食物攝取之因素………………………………9
第三章 研究對象與方法…………………………....…………………..13
第一節 研究設計與架構………….………...………………………..13
第二節 研究對象...………………..………………………………….15
第三節 資料收集方法...…………..………………………………….16
第四節 統計方法..……………..….………………………………….20
第四章 結果...……………..…………………………………………….21
第一節 樣本特性...………..………………………………………….21
第二節 不同哺育方式組別間受試者基本資料...…..… ……………26
第三節 產後體重保留量之分析...……………….……….……….....29
第四節 生產後體重減輕量之分析...…………….…………………..31
第五節 結果摘要...…………………………..………… ……………33
第五章 討論與結論...……………..……………………… ……………46
第一節 影響產後婦女體重變化之因素…………………….……….46
第二節 影響產後婦女食物攝取之因素……………………….…….50
第三節 結論………………………………………………………..…52
第六章 研究限制與未來建議之方向…………………………………..53
參考文獻…………………………………………………………………54
表目錄
表1 不同哺育方式組別間的人口特性差異.…………………………34
表2 不同哺育方式組別間在各時間的體重及身體質量指數差異.…35
表3 不同哺育方式組別間在產後各時間的熱量攝取差異.…………36
表4 不同哺育方式組別間在產後一個月的生活與健康相關習慣.…37
表5 不同哺育方式組別間在產後三個月的生活與健康相關習慣.…38
表6 不同哺育方式組別間在產後六個月的生活與健康相關習慣.…39
表7 影響產後一個月體重保留量的相關因子.………………………40
表8 影響產後三個月體重保留量的相關因子.………………………41
表9 影響產後六個月體重保留量的相關因子.………………………42
表10 影響生產後一個月體重減輕量之相關因子……………………43
表11 影響生產後三個月體重減輕量之相關因子……………………44
表12 影響生產後六個月體重減輕量之相關因子……………………45

圖目錄
圖一：研究架構圖.........................................14
圖二：研究實施流程圖.....................................18
圖三：產後體重保留量…………………………………………………23
圖四：生產後體重減輕量………………………………………………23
附錄表
附錄一婦女個人基本資料問卷………………………………………………62
附錄二產後一個月坐月子期間母嬰問卷……………………………………63
附錄三產後三個月母嬰問卷…………………………………………………65
附錄四產後六個月母嬰問卷..………………………………………………67
附錄五24小時飲食回憶空白問卷.…………………………………………70
附錄六飲食紀錄說明書………………………………………………………73
附錄七手掌模型-1號手掌(三兩手掌) .……………………………………76
附錄八手掌模型-2號手掌(四兩手掌)..……………………………………77
附錄九手掌模型-3號手掌(五兩手掌)..……………………………………78

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