Review
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Obezitenin Maternal ve Fetal Sağlık Üzerine Etkileri, Hemşirelik Yaklaşımı

Year 2019, Volume: 2 Issue: 2, 110 - 119, 30.09.2019

Abstract

Obezite
dünyada hızla yayılan ve gebeleri de ciddi şekilde etkileyen önemli bir halk
sağlığı problemidir. Obezite ve fazla kilolu olmak özellikle doğurganlık
çağındaki (15-49 yaş)  kadınlarda daha
yaygın görülmektedir. Obez gebeliklerde gestasyonel problemler, obstetrik
komplikasyonlar ve neonatal olumsuz sonuçlar daha fazla görülmektedir. Obezite
anne adayında gestasyonel diyabet, hipertansiyon, preeklampsi, tromboemboli,
uzamış doğum eylemi, sezaryen doğuma, postpartum dönemde ise yara enfeksiyonu,
emzirme problemlerine neden olabilmektedir. Fetüs için ise makrazomik bebek,
omuz distosisi, prematürite, doğum anomalisi, ölü doğuma neden olabilmekte ve
çocukluk ve adölesan dönemde obezite riskini artırmaktadır. Hemşireler obez
kadınlarda gebelik öncesi, gebelik dönemi 
ve sonrasında kilo kontrolünü sağlamalı, maternal ve fetal
komplikasyonlara karşı önlemler almalı, hastayı bütüncül bir şekilde
değerlendirmeli, prenatal, intrapartum ve postpartum dönemde etkili bakım
sunmalıdır. Bu derlemenin amacı obezitenin maternal ve fetal sağlık üzerine
etkilerini ve obstetride obezitenin yönetimine yönelik hemşirelik
yaklaşımlarını ele almaktır.

Supporting Institution

YOK

Project Number

YOK

References

  • Ahmed A, Delgado-Olguin P. (2019). Embryonic programming of heart disease in response to obesity during pregnancy. Biochimica et Biophysica Acta (BBA)-Molecular Basis of Disease, in press. DOI: https://doi.org/10.1016/j.bbadis.2019.01.028
  • American College of Obstetricians and Gynecologists (ACOG) (2015). Obesity in pregnancy. ACOG Practice bulletin No:156. Obstet Gynecol, 126, e112-e126. Erişim tarihi: 17.06.2019. https://insights.ovid.com/crossref?an=00006250-201512000-00055
  • Athukorala C, Rumbold AR, Willson KJ, Crowther CA. (2010). The risk of adverse pregnancy outcomes in women who are overweight or obese. BMC Pregnancy And Childbirth, 10(1), 56.
  • Ayres-de-Campos D. (2015). Obesity and the challenges of caesarean delivery: prevention and management of wound complications. Best Practice & Research Clinical Obstetrics & Gynaecology, 29(3), 406-414.
  • Bates SM, Greer IA, Middeldorp S, Veenstra DL, Prabulos AM, Vandvik PO. (2012). VTE, thrombophilia, antithrombotic therapy, and pregnancy: antithrombotic therapy and prevention of thrombosis: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest American College of Chest Physicians, 141(2), 691-736.
  • Catalano PM. (2007). Management of obesity in pregnancy. Obstetrics & Gynecology, 109(2), 419-433.
  • Chu SY, Bachman DJ, Callaghan WM, Whitlock EP, Dietz PM, Berg CJ ve ark. (2008). Association between obesity during pregnancy and increased use of health care. New England Journal of Medicine, 358(14), 1444-1453.
  • Daşıkan Z, Kavlak O. (2009). Maternal Obezite: Gebelik komplikasyonları ve gebe kadının yönetimi. Turkiye Klinikleri Journal of Nursing Sciences, 1(1), 39-46.
  • Daşıkan Z. (2015). Gebelikte kilo alımı: gebe kadınlar prenatal bakımda doğru kilo alım önerisi alıyor mu?(Ödemiş/İzmir). Journal of Clinical Obstetrics & Gynecology, 25(1), 32-38.
  • Davies GAL, Maxwell C, McLeod L, Gagnon R, Basso M, Bos H ve ark. (2010). Obesity in pregnancy. Journal Of Obstetrics And Gynaecology Canada, 32(2), 165-173.
  • Doğum Sonu Bakım Yönetimi Rehberi (2014). T.C. Sağlık Bakanlığı Türkiye Halk Sağlığı Kurumu Kadın ve Üreme Sağlığı Daire Başkanlığı, Ankara, Yayın No: 925. Erişim Tarihi: 17.06.2019 https://sbu.saglik.gov.tr/ Ekutuphane/kitaplar/dsbyr_2.pdf
  • Farah N, Maher N, Barry S, Kennelly M, Stuart B, Turner MJ. (2009). Maternal morbid obesity and obstetric outcomes. Obesity Facts The European Journal of Obesity, 2(6), 352-354.
  • Frederick IO, Qiu C, Sorensen TK, Enquobahrie DA, Williams MA. (2013). The prevalence and correlates of habitual snoring during pregnancy. Sleep and Breathing International Journal of Science and Sleep Medicine Practice, 17(2), 541-547.
  • Ge X, Tao F, Huang K, Mao L, Huang, S, Niu Y ve ark. (2016). Mother snoring can predict the negative consequences of pregnancy: a cohort study in China. PLoS 1, 11(2), e0148732.
  • Glazer NL, Hendrickson AF., Schellenbaum GD, Mueller BA. (2004). Weight change and the risk of gestational diabetes in obese women. Epidemiology, 15(6), 733-737.
  • Guelinckx I, Devlieger R, Beckers K, Vansant G. (2008). Maternal obesity: pregnancy complications, gestational weight gain and nutrition. Obesity Reviews, 9(2), 140-150.
  • Hajagos-Tóth J, Ducza E, Samavati R, Vari SG, Gaspar R. (2017). Obesity in pregnancy: a novel concept on the roles of adipokines in uterine contractility. Croatian Medical Journal, 58(2), 96-106.
  • Heslehurst N, Simpson H, Ells LJ, Rankin J, Wilkinson J, Lang R ve ark. (2008). The impact of maternal BMI status on pregnancy outcomes with immediate short‐term obstetric resource implications: a meta-analysis. Obesity Reviews, 9(6), 635-683.
  • Institute of Medicine (US) and National Research Council (US) Committee to Reexamine IOM Pregnancy Weight Guidelines.Kathleen M Rasmussen and Ann L Yaktine, editors. Washington (DC): National Academies Press (US); 2009. ISBN-13: 978-0-309-13113-1, .ncbi.nlm.nih.gov/books/NBK32813/, Erişim tarihi: 05.05.2019
  • Jain AP, Gavard JA, Rice JJ, Catanzaro RB, Artal R, Hopkins SA. (2013). The impact of interpregnancy weight change on birthweight in obese women. American Journal of Obstetrics and Gynecology, 208(3), 205-e1.
  • Jarlenski MP, Bennett WL, Bleich SN, Barry CL, Stuart EA. (2014). Effects of breastfeeding on postpartum weight loss among US women. Preventive medicine, 69, 146-150. Jevitt C. (2009). Pregnancy complicated by obesity: midwifery management. Journal of Midwifery & Women's Health, 54(6), 445-451.
  • Jolly MC, Sebire NJ, Harris JP, Regan L, Robinson S. (2003). Risk factors for macrosomia and its clinical consequences: a study of 350,311 pregnancies. European Journal of Obstetrics & Gynecology and Reproductive Biology, 111(1), 9-14.
  • Kara M, Üstün YE. (2017). obezitenin kadınlarda fertilite ve gebelik üzerindeki etkileri. Bozok Tıp Dergisi, 7(1), 70-73.
  • Kim SS, Zhu Y, Grantz KL, Hinkle SN, Chen Z, Wallace ME, Smarr MM ve ark. (2016). Obstetric and neonatal risks among obese women without chronic disease. Obstetrics and gynecology, 128(1), 104.
  • Leth RA, Uldbjerg N, Norgaard M, Moller JK, Thomsen RW. (2011). Obesity, diabetes, and the risk of infections diagnosed in hospital and post discharge infections after cesarean section: a prospective cohort study. AOGS Acta Obstetricia et Gynecologica Scandinavica, 90(5), 501-509.
  • Madan JC, Davis JM, Craig WY, Collins M, Allan W, Quinn R ve ark. (2009). Maternal obesity and markers of inflammation in pregnancy. An Official Journal of the International Cytokine & Interferon Society (ICIS), 47(1), 61-64.
  • Majumdar A, Saleh S, Candelier CK. (2010). Failure to recognise the impact of ‘moderate’obesity (BMI 30–40) on adverse obstetric outcomes. Journal of Obstetrics and Gynaecology, 30(6), 567-570.
  • Marchi J, Berg M, Dencker A, Olander EK, Begley C. (2015). Risks associated with obesity in pregnancy, for the mother and baby: a systematic review of reviews. Obesity Reviews, 16(8), 621-638.
  • McGuire W, Dyson L, Renfrew M. (2010). Maternal obesity: consequences for children, challenges for clinicians and carers. In Seminars in Fetal and Neonatal Medicine, 15(2), 108-112.
  • Melchor I, Burgos J, Del Campo A,Aiartzaguena A, Gutiérrez J, Melchor JC. (2019). Effect of maternal obesity on pregnancy outcomes in women delivering singleton babies: a historical cohort study. Official Journal of the World Association of Perinatal Medicine, in press. DOI:https://doi.org/10.1515/jpm-2019-0103
  • Mission JF, Marshall NE, Caughey AB. (2015). Pregnancy risks associated with obesity. Obstetrics and Gynecology Clinics,42(2), 335-353.
  • Oken E, Rifas-Shiman SL, Field AE, Frazier AL, Gillman MW. (2008). Maternal gestational weight gain and offspring weight in adolescence. Obstetrics and Gynecology, 112(5), 999.
  • Opray N, Grivell RM, Deussen AR, Dodd JM. (2015). Directed preconception health programs and interventions for improving pregnancy outcomes for women who are overweight or obese. Cochrane Database of Systematic Reviews, (7).
  • Ovesen P, Rasmussen S, Kesmodel U. (2011). Effect of prepregnancy maternal over weight and obesity on pregnancy outcome. Obstetrics & Gynecology (The Green Journal), 118(2), 305-312.
  • Özcan A, Töz E, Özvatan SH, Vural T, Sancı M. (2016). Obez gebeliklerin yönetimi. Tepecik Eğitim ve Araştırma Hastanesi Dergisi, 26(1), 1-9.
  • Phatak M, Ramsay J. (2010). Impact of maternal obesity on procedure of mid-trimester anomaly scan. Journal of Obstetrics and Gynaecology, 30(5), 447-450.
  • Rocha ALL, Campos RR, Miranda MM, Raspante LB, Carneiro MM, Vieira CS, Reis FM. (2017). Safety of hormonal contraception for obese women. Expert Opinion on Drug Safety, 16(12), 1387-1393.
  • Shaikh H, Robinson S, Teoh T. G. (2010). Management of maternal obesity prior to and during pregnancy. In Seminars in Fetal and Neonatal Medicine, 15(2), 77-82.
  • Sirimi N, Goulis DG. (2010). Obesity in pregnancy. Hormones International Journal of Endocrinology and Metabolism, 9(4), 299-306.
  • Tenenbaum-Gavish K, Hod M. (2013). Impact of maternal obesity on fetal health. Fetal diagnosis and therapy, 34(1), 1-7.
  • Thangaratinam S, Rogozińska E, Jolly K, Glinkowski S, Duda W, Borowiack E ve ark. (2012). Interventions to reduce or prevent obesity in pregnant women: a systematic review. In NIHR Health Technology Assessment programme: Executive Summaries. National Institute for Health Research Journals Library.
  • Thornburg LL, Miles K, Ho M, Pressman EK. (2009). Fetal anatomic evaluation in the overweight and obese gravida. Ultrasound in Obstetrics and Gynecology, 33(6), 670-675.
  • Ulaşlı SS, Ünlü M. (2014). Gebelikte uyku sorunları. Güncel Göğüs Hastalıkları Serisi, 2(2), 237-244.
  • Väänänen, AJ, Kainu JP, Eriksson H, Lång M, Tekay A, Sarvela J. (2017). Does obesity complicate regional anesthesia and result in longer decision to delivery time for emergency cesarean section?. Acta Anaesthesiologica Scandinavica, 61(6), 609-618.
  • Wax, JR (2009). Risks and management of obesity in pregnancy: current discussions. Current Opinion in Obstetrics and Gynecology , 3 (3), 117-123.
  • World Health Organization. (2010). Reproductive Health. (2010). Medical eligibility criteria for contraceptive use. Erişim Tarihi: 17.06.2019 https://www.who.int/reproductivehealth/publications/family_planning/Ex-Summ-MEC-5/en/
  • World Health Organization. (2013) Obesity and Overweight. WHO Situtations Reports, 2013. Erişim Tarihi: 17.06.2019 https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight
  • Yıldırım M, Akyol A, Ersoy G. (2008). Şişmanlık (Obezite) ve Fiziksel Aktivite. 1. Baskı, Ankara, Klasmat Matbaacılık, s. 14.

The Effects of Obesity on Maternal and Fetal Health, Nursing Approach

Year 2019, Volume: 2 Issue: 2, 110 - 119, 30.09.2019

Abstract

Obesity
is an important public health problem that is rapidly spreading in the world
and affecting pregnant women. Obesity and overweight are more common in women
of childbearing age (15-49 years). Gestational problems, obstetric
complications and neonatal adverse outcomes are more common in obese
pregnancies. Obesity may cause gestational diabetes, hypertension,
preeclampsia, thromboembolism, prolonged labor, caesarean delivery and postpartum
wound infection and breastfeeding problems in the mothers. For the fetus,
macrazomic infant can cause shoulder dystocia, premature birth, birth anomaly,
stillbirth and increase the risk of obesity in childhood and adolescence.
Nurses should provide weight control in obese women before, during and after
pregnancy, should take precautions against maternal and fetal complications,
evaluate the patient holistically, and provide effective care during prenatal,
intrapartum and postaprtum periods. The aim of this review is to discuss the
effects of obesity on maternal and fetal health and nursing approaches to the
management of obesity in obstetrics.



 

Project Number

YOK

References

  • Ahmed A, Delgado-Olguin P. (2019). Embryonic programming of heart disease in response to obesity during pregnancy. Biochimica et Biophysica Acta (BBA)-Molecular Basis of Disease, in press. DOI: https://doi.org/10.1016/j.bbadis.2019.01.028
  • American College of Obstetricians and Gynecologists (ACOG) (2015). Obesity in pregnancy. ACOG Practice bulletin No:156. Obstet Gynecol, 126, e112-e126. Erişim tarihi: 17.06.2019. https://insights.ovid.com/crossref?an=00006250-201512000-00055
  • Athukorala C, Rumbold AR, Willson KJ, Crowther CA. (2010). The risk of adverse pregnancy outcomes in women who are overweight or obese. BMC Pregnancy And Childbirth, 10(1), 56.
  • Ayres-de-Campos D. (2015). Obesity and the challenges of caesarean delivery: prevention and management of wound complications. Best Practice & Research Clinical Obstetrics & Gynaecology, 29(3), 406-414.
  • Bates SM, Greer IA, Middeldorp S, Veenstra DL, Prabulos AM, Vandvik PO. (2012). VTE, thrombophilia, antithrombotic therapy, and pregnancy: antithrombotic therapy and prevention of thrombosis: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest American College of Chest Physicians, 141(2), 691-736.
  • Catalano PM. (2007). Management of obesity in pregnancy. Obstetrics & Gynecology, 109(2), 419-433.
  • Chu SY, Bachman DJ, Callaghan WM, Whitlock EP, Dietz PM, Berg CJ ve ark. (2008). Association between obesity during pregnancy and increased use of health care. New England Journal of Medicine, 358(14), 1444-1453.
  • Daşıkan Z, Kavlak O. (2009). Maternal Obezite: Gebelik komplikasyonları ve gebe kadının yönetimi. Turkiye Klinikleri Journal of Nursing Sciences, 1(1), 39-46.
  • Daşıkan Z. (2015). Gebelikte kilo alımı: gebe kadınlar prenatal bakımda doğru kilo alım önerisi alıyor mu?(Ödemiş/İzmir). Journal of Clinical Obstetrics & Gynecology, 25(1), 32-38.
  • Davies GAL, Maxwell C, McLeod L, Gagnon R, Basso M, Bos H ve ark. (2010). Obesity in pregnancy. Journal Of Obstetrics And Gynaecology Canada, 32(2), 165-173.
  • Doğum Sonu Bakım Yönetimi Rehberi (2014). T.C. Sağlık Bakanlığı Türkiye Halk Sağlığı Kurumu Kadın ve Üreme Sağlığı Daire Başkanlığı, Ankara, Yayın No: 925. Erişim Tarihi: 17.06.2019 https://sbu.saglik.gov.tr/ Ekutuphane/kitaplar/dsbyr_2.pdf
  • Farah N, Maher N, Barry S, Kennelly M, Stuart B, Turner MJ. (2009). Maternal morbid obesity and obstetric outcomes. Obesity Facts The European Journal of Obesity, 2(6), 352-354.
  • Frederick IO, Qiu C, Sorensen TK, Enquobahrie DA, Williams MA. (2013). The prevalence and correlates of habitual snoring during pregnancy. Sleep and Breathing International Journal of Science and Sleep Medicine Practice, 17(2), 541-547.
  • Ge X, Tao F, Huang K, Mao L, Huang, S, Niu Y ve ark. (2016). Mother snoring can predict the negative consequences of pregnancy: a cohort study in China. PLoS 1, 11(2), e0148732.
  • Glazer NL, Hendrickson AF., Schellenbaum GD, Mueller BA. (2004). Weight change and the risk of gestational diabetes in obese women. Epidemiology, 15(6), 733-737.
  • Guelinckx I, Devlieger R, Beckers K, Vansant G. (2008). Maternal obesity: pregnancy complications, gestational weight gain and nutrition. Obesity Reviews, 9(2), 140-150.
  • Hajagos-Tóth J, Ducza E, Samavati R, Vari SG, Gaspar R. (2017). Obesity in pregnancy: a novel concept on the roles of adipokines in uterine contractility. Croatian Medical Journal, 58(2), 96-106.
  • Heslehurst N, Simpson H, Ells LJ, Rankin J, Wilkinson J, Lang R ve ark. (2008). The impact of maternal BMI status on pregnancy outcomes with immediate short‐term obstetric resource implications: a meta-analysis. Obesity Reviews, 9(6), 635-683.
  • Institute of Medicine (US) and National Research Council (US) Committee to Reexamine IOM Pregnancy Weight Guidelines.Kathleen M Rasmussen and Ann L Yaktine, editors. Washington (DC): National Academies Press (US); 2009. ISBN-13: 978-0-309-13113-1, .ncbi.nlm.nih.gov/books/NBK32813/, Erişim tarihi: 05.05.2019
  • Jain AP, Gavard JA, Rice JJ, Catanzaro RB, Artal R, Hopkins SA. (2013). The impact of interpregnancy weight change on birthweight in obese women. American Journal of Obstetrics and Gynecology, 208(3), 205-e1.
  • Jarlenski MP, Bennett WL, Bleich SN, Barry CL, Stuart EA. (2014). Effects of breastfeeding on postpartum weight loss among US women. Preventive medicine, 69, 146-150. Jevitt C. (2009). Pregnancy complicated by obesity: midwifery management. Journal of Midwifery & Women's Health, 54(6), 445-451.
  • Jolly MC, Sebire NJ, Harris JP, Regan L, Robinson S. (2003). Risk factors for macrosomia and its clinical consequences: a study of 350,311 pregnancies. European Journal of Obstetrics & Gynecology and Reproductive Biology, 111(1), 9-14.
  • Kara M, Üstün YE. (2017). obezitenin kadınlarda fertilite ve gebelik üzerindeki etkileri. Bozok Tıp Dergisi, 7(1), 70-73.
  • Kim SS, Zhu Y, Grantz KL, Hinkle SN, Chen Z, Wallace ME, Smarr MM ve ark. (2016). Obstetric and neonatal risks among obese women without chronic disease. Obstetrics and gynecology, 128(1), 104.
  • Leth RA, Uldbjerg N, Norgaard M, Moller JK, Thomsen RW. (2011). Obesity, diabetes, and the risk of infections diagnosed in hospital and post discharge infections after cesarean section: a prospective cohort study. AOGS Acta Obstetricia et Gynecologica Scandinavica, 90(5), 501-509.
  • Madan JC, Davis JM, Craig WY, Collins M, Allan W, Quinn R ve ark. (2009). Maternal obesity and markers of inflammation in pregnancy. An Official Journal of the International Cytokine & Interferon Society (ICIS), 47(1), 61-64.
  • Majumdar A, Saleh S, Candelier CK. (2010). Failure to recognise the impact of ‘moderate’obesity (BMI 30–40) on adverse obstetric outcomes. Journal of Obstetrics and Gynaecology, 30(6), 567-570.
  • Marchi J, Berg M, Dencker A, Olander EK, Begley C. (2015). Risks associated with obesity in pregnancy, for the mother and baby: a systematic review of reviews. Obesity Reviews, 16(8), 621-638.
  • McGuire W, Dyson L, Renfrew M. (2010). Maternal obesity: consequences for children, challenges for clinicians and carers. In Seminars in Fetal and Neonatal Medicine, 15(2), 108-112.
  • Melchor I, Burgos J, Del Campo A,Aiartzaguena A, Gutiérrez J, Melchor JC. (2019). Effect of maternal obesity on pregnancy outcomes in women delivering singleton babies: a historical cohort study. Official Journal of the World Association of Perinatal Medicine, in press. DOI:https://doi.org/10.1515/jpm-2019-0103
  • Mission JF, Marshall NE, Caughey AB. (2015). Pregnancy risks associated with obesity. Obstetrics and Gynecology Clinics,42(2), 335-353.
  • Oken E, Rifas-Shiman SL, Field AE, Frazier AL, Gillman MW. (2008). Maternal gestational weight gain and offspring weight in adolescence. Obstetrics and Gynecology, 112(5), 999.
  • Opray N, Grivell RM, Deussen AR, Dodd JM. (2015). Directed preconception health programs and interventions for improving pregnancy outcomes for women who are overweight or obese. Cochrane Database of Systematic Reviews, (7).
  • Ovesen P, Rasmussen S, Kesmodel U. (2011). Effect of prepregnancy maternal over weight and obesity on pregnancy outcome. Obstetrics & Gynecology (The Green Journal), 118(2), 305-312.
  • Özcan A, Töz E, Özvatan SH, Vural T, Sancı M. (2016). Obez gebeliklerin yönetimi. Tepecik Eğitim ve Araştırma Hastanesi Dergisi, 26(1), 1-9.
  • Phatak M, Ramsay J. (2010). Impact of maternal obesity on procedure of mid-trimester anomaly scan. Journal of Obstetrics and Gynaecology, 30(5), 447-450.
  • Rocha ALL, Campos RR, Miranda MM, Raspante LB, Carneiro MM, Vieira CS, Reis FM. (2017). Safety of hormonal contraception for obese women. Expert Opinion on Drug Safety, 16(12), 1387-1393.
  • Shaikh H, Robinson S, Teoh T. G. (2010). Management of maternal obesity prior to and during pregnancy. In Seminars in Fetal and Neonatal Medicine, 15(2), 77-82.
  • Sirimi N, Goulis DG. (2010). Obesity in pregnancy. Hormones International Journal of Endocrinology and Metabolism, 9(4), 299-306.
  • Tenenbaum-Gavish K, Hod M. (2013). Impact of maternal obesity on fetal health. Fetal diagnosis and therapy, 34(1), 1-7.
  • Thangaratinam S, Rogozińska E, Jolly K, Glinkowski S, Duda W, Borowiack E ve ark. (2012). Interventions to reduce or prevent obesity in pregnant women: a systematic review. In NIHR Health Technology Assessment programme: Executive Summaries. National Institute for Health Research Journals Library.
  • Thornburg LL, Miles K, Ho M, Pressman EK. (2009). Fetal anatomic evaluation in the overweight and obese gravida. Ultrasound in Obstetrics and Gynecology, 33(6), 670-675.
  • Ulaşlı SS, Ünlü M. (2014). Gebelikte uyku sorunları. Güncel Göğüs Hastalıkları Serisi, 2(2), 237-244.
  • Väänänen, AJ, Kainu JP, Eriksson H, Lång M, Tekay A, Sarvela J. (2017). Does obesity complicate regional anesthesia and result in longer decision to delivery time for emergency cesarean section?. Acta Anaesthesiologica Scandinavica, 61(6), 609-618.
  • Wax, JR (2009). Risks and management of obesity in pregnancy: current discussions. Current Opinion in Obstetrics and Gynecology , 3 (3), 117-123.
  • World Health Organization. (2010). Reproductive Health. (2010). Medical eligibility criteria for contraceptive use. Erişim Tarihi: 17.06.2019 https://www.who.int/reproductivehealth/publications/family_planning/Ex-Summ-MEC-5/en/
  • World Health Organization. (2013) Obesity and Overweight. WHO Situtations Reports, 2013. Erişim Tarihi: 17.06.2019 https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight
  • Yıldırım M, Akyol A, Ersoy G. (2008). Şişmanlık (Obezite) ve Fiziksel Aktivite. 1. Baskı, Ankara, Klasmat Matbaacılık, s. 14.
There are 48 citations in total.

Details

Primary Language Turkish
Subjects Nursing
Journal Section Review
Authors

Derya Yüksel Koçak 0000-0001-6890-6755

Dilek Bingöl 0000-0002-8515-0758

Project Number YOK
Publication Date September 30, 2019
Submission Date July 4, 2019
Published in Issue Year 2019 Volume: 2 Issue: 2

Cite

APA Koçak, D. Y., & Bingöl, D. (2019). Obezitenin Maternal ve Fetal Sağlık Üzerine Etkileri, Hemşirelik Yaklaşımı. Ordu Üniversitesi Hemşirelik Çalışmaları Dergisi, 2(2), 110-119.