분만종류에 따른 고령 산후 여성의 저항성 운동이 신체구성, 신체둘레 및 기초체력에 미치는 영향 = Effects of resistance training on body composition, body circumference, and physical fitness in older postpartum women by type of delivery

다국어 초록 (Multilingual Abstract)

Background: In 2013, the average age of Korean women giving birth to their first child was 30.7 years, meaning South Korea has the ‘oldest average for first-time mothers’ among OECD countries (Statistics Korea, 2014). The reason for the increase in the age at first birth can be attributed to the increase in the age at first marriage. The range of age increase appeared to be similar to prior years, but the age of first marriage actually increased by about two years from 27.3 in 2003 to 29.8 in 2014. The average age for first-time mothers also increased by about two years from 28.6 in 2003 to 30.9 in 2014. According to the number of cesarean section deliveries by age announced by the National Health Insurance Corporation in 2012, the number of cesarean section deliveries for those in their 30s or older is increasing every year. In particular, the average annual increase in the number of cesarean section deliveries starting in the late 30s was found to be extremely high, 25.9%. Compared to natural childbirth, such cesarean section delivery poses greater risks to the fetus and mother, and excessive social costs are incurred as well. As modern medicine has developed, cesarean section has been implemented as a solution for women who are exposed to pain and the risk of death due to a difficult birth. However, since no procedure is perfect, cesarean section delivery can cause numerous side effects. Compared to natural childbirth, cesarean section delivery is reported to have a much higher maternal mortality rate and perinatal morbidity due to complications such as infection, bleeding, and anesthesia. Many previous studies have already shown that the maternal mortality rate of cesarean section delivery is approximately 2 to 4 times higher than that of natural delivery and that various complications resulting from cesarean section delivery are 5 to 10 times higher than those found with natural delivery. For this reason, the WHO also believes that the caesarean section delivery rate compared to all deliveries should not exceed 5-15% when considering current medical technology. However, in Korea, the caesarean section delivery rate increased from 18.1% in 1990 to 40.5% in 2001, but has shown a slight decline since then.

Methods: The initial number of study subjects was 30, but 2 subjects exited the study due to personal reasons, so the final number of subjects included in the study was 28. For data processing, the following techniques were applied to each dependent variable using SPSS 28.0, The significance level was verified at p<0.05. First, Descriptive analysis was performed to determine the average and standard deviation of each item. Second, The normality test of the study variables was confirmed by Shapiro-wilk. In addition, parameter statistical analysis and nonparametric statistical analysis were performed together for items that did not satisfy normality. Third, In order to verify the change before and after the resistance movement between groups, it was analyzed using the paired T-test method. Fourth, A pre- and post-independent T-test was conducted to see the difference between the groups.

Results: In this study, postpartum resistance exercise was performed by mothers who gave birth. Group A, who had a natural birth, showed significant differences in the right arm, left arm, abdomen, waist, buttocks, and right leg. Group B, which had a cesarean section, showed significant differences in the right arm, left arm, abdomen, waist, buttocks, and left leg. In other words, the results indicate that postpartum resistance exercise has the effect of reducing body circumference regardless of the period. Previous studies have shown that cesarean section delivery is more effective than natural childbirth in terms of body fat percentage. However, in this study, however, the natural childbirth group showed greater changes in body composition, body circumference, and basic physical strength. The results of this study are as follows. First, postpartum resistance exercise was shown to have an effect on the mother's body composition, body circumference, and basic physical strength. Second, the natural childbirth group showed relatively superior body composition, body circumference, and basic physical strength. Third, it was found that there was no difference between the method of childbirth with respect to body composition, body circumference, and basic physical strength when performing resistance exercise.

Conclusions: The purpose of this study was to investigate the effect of resistance exercise on body composition, body circumference, and basic physical strength of advanced maternal-age women by having them perform resistance exercise for 4 weeks. By analyzing the effects of postpartum resistance exercise according to the method of childbirth, the effects of natural childbirth and cesarean section birth were compared and analyzed to determine the effect on mothers depending on the method of childbirth. A postpartum resistance exercise program was implemented for mothers, and a comparative analysis was conducted on the effects on those mothers depending on the method of childbirth. Based on the results, this study has the following suggestions. First, there is a need for future research with more subjects over a longer term. Second, in future research, it is necessary to classify the number of months from the childbirth date and the postpartum period according to the delivery method and ascertain whether there are any differences between exercise programs. Through this, we will be able to provide more diverse and efficient exercise programs to postpartum mothers.

목차 (Table of Contents)

• Ⅰ. 서 론 1
• 1. 연구의 필요성 1
• 2. 연구의 목적 4
• 3. 연구의 가설 5
• 4. 연구의 제한점 5
• 5. 용어의 정의 6
• Ⅱ. 이론적 배경 7
• 1. 고령 임신 7
• 2. 제왕절개분만 8
• 3. 산후관리 9
• 4. 산후운동 10
• 5. 출산 후 건강관련 체력변화 11
• 1) 심폐지구력의 변화 11
• 2) 근력의 변화 11
• 3) 근지구력의 변화 11
• 4) 유연성의 변화 12
• 5) 신체구성의 변화 12
• 6) 저항성 운동 13
• Ⅲ. 연구 방법 14
• 1. 연구 대상 14
• 2. 연구 기간 15
• 3. 연구 설계 15
• 4. 연구 절차 16
• 5. 측정 방법 및 내용 18
• 6. 자료 처리 21
• Ⅳ. 연구 결과 22
• 1. 운동 전 정규성 검증 22
• 2. 사전 정규성 검증 22
• 3. 집단 간 사전-사후 점수 차이 정규성 검증 24
• 4. 집단 간 전, 후 결과 24
• 5. 사전-사후 차이 정규성 검증 27
• 6. 운동 전, 후 집단별 변화량 27
• Ⅴ. 논의 29
• Ⅵ. 결론 및 제언 31
• 참고문헌 32
• ABSTRACT 41