Impacto do estilo de vida na adaptação individual e relacional e nos resultados obstétricos de mulheres adultas após o parto

Autores

  • Daniela Centenaro Levandowski Universidade Federal de Ciências da Saúde de Porto Alegre
  • Marco Pereira Universidade de Coimbra
  • Mariana Moura­‑Ramos Universidade de Coimbra
  • Maria Cristina Canavarro Universidade de Coimbra

DOI:

https://doi.org/10.14195/1647-8606_61-2_5

Palavras-chave:

estilo de vida, gravidez, resultados obstétricos, adaptação psicológica

Resumo

O objetivo deste estudo foi analisar e comparar retrospetivamente o estilo de vida (EV) de mulheres antes e durante a gravidez; descrever a adaptação individual e relacional na transição para a maternidade e os resultados obstétricos; e avaliar a associação entre hábitos de EV e estes indicadores. A amostra foi composta por 98 mães, a maioria casadas ou em união de facto, com ensino secundário ou superior, nulíparas e que planearam a gravidez. A bateria de avaliação incluiu um questionário sociodemográfico, a Escala de Avaliação das Emoções, o Inventário de Sintomas Psicopatológicos e escalas de adjetivos para avaliar os domínios conjugal e parental. Os resultados mostraram uma mudança positiva no EV durante a gravidez em comparação ao período precedente. Foi encontrada uma associação significativa entre a adoção de hábitos de vida saudáveis e menor sintomatologia psicopatológica e maior reatividade emocional positiva. Estes resultados salientam a importância da avaliação de diferentes componentes do EV e a sua associação com diversos indicadores individuais e relacionais para uma melhor compreensão da adaptação das mulheres na transição para a maternidade.

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Referências

Abdel-Latif, M. E., Bajuk, B., Lui, K., Oei, J., & NSW on ACT Neonatal Intensive Care Units’ Study (NICUS) Group. (2007). Short-term outcomes of infants of substance-using mothers admitted to neonatal intensive care units in New South Wales and the Australian Capital Territory. Journal of Paediatrics and Child Health, 43(3), 127-133. doi: 10.1111/j.1440-1754.2007.01031.x

Afonso, F., & Pereira, M. G. (2013). Morbidade, suporte do parceiro e representações do tabaco em fumantes e abstinentes. Estudos e Pesquisas em Psicologia, 13(3), 1068-1088.

Bakker, R., Steegers, E. A., Obradov, A., Raat, H., Hofman, A., & Jaddoe, V. W. (2010). Maternal caffeine intake from coffee and tea, fetal growth, and the risks of adverse birth outcomes: The Generation R Study. The American Journal of Clinical Nutrition, 91(6), 1691-1698. doi: 10.3945/ajcn.2009.28792

Barros, P. P. (2003). Estilos de vida e estado de saúde: Uma estimativa da função de produção de saúde. Revista Portuguesa de Saúde Pública, 3, 7-17.

Bech, B. H., Nohr, E. A., Vaeth, M., Henriksen, T. B., & Olsen, J. (2005). Coffee and fetal death: A cohort study with prospective data. American Journal of Epidemiology, 162(10), 983-990. doi: 10.1093/aje/kwi317

Buscicchio, G., Piemontese, M., Gentilucci, L., Ferretti, F., & Tranquilli, A. L. (2012). The effects of maternal caffeine and chocolate intake on fetal heart rate. Journal of Maternal-Fetal and Neonatal Medicine, 25(5), 528-530. doi: 10.3109/14767058.2011.636104

Canavarro, M. C. (2001). Gravidez e maternidade: Representações e tarefas de desenvolvimento. In M. C. Canavarro (Ed.), Psicologia da gravidez e da maternidade (pp. 323-359). Coimbra: Quarteto.

Canavarro, M. C. (2007). Inventário de Sintomas Psicopatológicos (BSI): Uma revisão crítica dos estudos realizados em Portugal. In M. R. Simões, C. Machado, M. Gonçalves & L. Almeida (Coord.), Avaliação psicológica. Instrumentos validados para a população Portuguesa, (vol. III, pp. 305-331). Coimbra: Quarteto Editora.

Carlson, C. R., Collins, F. L., Stewart, J. F., Porzelius, J., Nitz, J. A., & Lind, C. O. (1989). The assessment of emotional reactivity: A scale development and validation study. Journal of Psychopathology and Behavioral Assessment, 11(4), 313-325. doi: 10.1007/BF00961530

Chiriboga, C. A., Kuhn, L., & Wasserman, G. A. (2007). Prenatal cocaine exposures and dose-related cocaine effects on infant tone and behavior. Neurotoxicology and Teratology, 29(3), 323-330. doi: 10.1016/j.ntt.2006.12.002

Conde, A., Teves, C., & Figueiredo, B. (2011). Maternal coffee intake and associated risk factors: Effects on fetal growth and activity. Acta Médica Portuguesa, 24(2), 241-248.

Coo, S., Milgrom, J., & Trinder, J. (2014). Mood and objective and subjective measures of sleep during late pregnancy and the postpartum period. Behavioral Sleep Medicine, 12(4), 317-330. doi: 10.1080/15402002.2013.801348

Coutinho, E. C., Silva, C. B., Chaves, C. M. B., Nelas, P. A., Parreira, V. B., Amaral, M. O., & Duarte, J. C. (2014). Pregnancy and childbirth: What changes in the lifestyle of women who become mothers? Revista da Escola de Enfermagem da USP, 48(2), 17-24. doi: 10.1590/S0080-623420140000800004

Crozier, S. R., Robinson, S. M., Borland, S. E., Godfrey, K. M., Cooper, C., Inskip, H. M., & SWS Study Group. (2009). Do women change their health behaviours in pregnancy? Findings from the Southampton Women’s Survey. Paediatric and Perinatal Epidemiology, 23(5), 446-453. doi: 10.1111/j.1365-3016.2009.01036.x

Cunha Filho, H. (2005). Necessidades de intervenção no consumo de álcool, tabaco e outras drogas em Portugal. Intervenção em Saúde, 23(2), 77-88.

Da Costa, D., Brender, W., & Larouche, J. (1998). A prospective study of the impact of psychosocial and lifestyle variables on pregnancy complications. Journal of Psychosomatic Obstetrics & Gynecology, 19(1), 28-37. doi: 10.3109/01674829809044218

Da Costa, D., Rippen, N., Dritsa, M., & Ring, A. (2003). Self-reported leisure-time physical activity during pregnancy and relationship to psychological well-being. Journal of Psychosomatic Obstetrics & Gynecology, 24(2), 111-119. doi: 10.3109/01674820309042808

Davenport, M. H., Ruchat, S., Giroux, I., Sopper, M. M., & Mottola, M. F. (2013). Timing of excessive pregnancy-related weight gain and offspring adiposity at birth. Obstetrics and Gynecology, 122(2), 255-261. doi: 10.1097/AOG.0b013e31829a3b86

Davies, G. A., Wolfe, L. A., Mottola, M. F., MacKinnon, C., Arsenault, M. Y., Bartellas, E., … Trudeau F. (2003). Exercise in pregnancy and the postpartum period. Journal of Obstetrics and Gynaecology Canada, 25(6), 516–529. doi: 10.1016/S1701-2163(16)30313-9

Dekker, G. A., Lee, S. Y., North, R. A., McCowan, L. M., Simpson, N. A. B., & Roberts, C. T. (2012). Risk factors for preterm birth in an international prospective cohort of nulliparous women. PLoS ONE 7(7), 39154. doi: 10.1371/journal.pone.0039154

Derogatis, L. R. (1993). BSI: Brief Symptom Inventory: Administration, scoring and procedures manual. Minneapolis: Natural Computers System.

Domingues, M. R., Barros, A. J., & Matijasevich, A. (2008). Leisure time physical activity during pregnancy and preterm birth in Brazil. International Journal of Gynaecology and Obstetrics, 103(1), 9-15. doi: 10.1016/j.ijgo.2008.05.029

Edvardsson, K., Ivarsson, A., Eurenius, E., Garvare, R., Nyström, M. E., Small, R., & Mogren, I. (2011). Giving offspring a healthy start: Parents’ experiences of health promotion and lifestyle change during pregnancy and early parenthood. BMC Public Health, 11, 936. doi: 10.1186/1471-2458-11-936

Elsinga, J., Jong-Potjer, L. C., van der Pal-de Bruin, K. M., Cessie, S., Assendelft, W. J., & Buitendijk, S. E. (2008). The effect of preconception counselling on lifestyle and other behaviour before and during pregnancy. Women’s Health Issues, 18 (Suppl. 6), S117–S125. doi: 10.1016/j.whi.2008.09.003

Evenson, K. R., Siega-Riz, A. M., Savitz, D. A., Leiferman, J. A., & Thorp, J. M. Jr. (2002). Vigorous leisure activity and pregnancy outcomes. Epidemiology, 13(6), 653-659. doi: 10.1097/01.EDE.0000021463.45041.95

Forno, E., Young, O. M., Kumar, R., Simhan, H., & Celedón, J. C. (2014). Maternal obesity in pregnancy, gestational weight gain, and risk of childhood asthma. Pediatrics, 134(2), 535-546. doi: 10.1542/peds.2014-0439

Foxcroft, K. F., Rowlands, I. J., Byrne, N. M., McIntyre, H. D., Callaway, L. K., & The Bambino Group (2011). Exercise in obese pregnant women: The role of social factors, lifestyle, and pregnancy symptoms. BMC Pregnancy and Childbirth, 11. doi: 10.1186/1471-2393-11-4

Gao, W., Paterson, J., Carter, S., & Percival, T. (2006). Risk factors for preterm and small-for-gestational-age babies: A cohort from the Pacific Islands Family Study. Journal of Paediatrics and Child Health, 42(12), 785-792. doi: 10.1111/j.1440-1754.2006.00978.x

Hammoud, A. O., Gibson, M., Peterson, C. M., Meikle, A. W., & Carrell, D. T. (2008). Impact of male obesity on infertility: A critical review of the current literature. Fertility and Sterility, 90(4), 897-904. doi: 10.1016/j.fertnstert.2008.08.026

Hedman, C., Pohjasvaara, T., Tolonen, U., Suhonen-Malm, A. S., & Myllyla, V. V. (2002). Effects of pregnancy on mothers’ sleep. Sleep Medicine, 3(1), 37-42. doi: 10.1016/S1389-9457(01)00130-7

Hegaard, H. K., Damm, P., Hedegarrd, M., Henriksen, T. B., Ottesen, B., Dykes, A., & Kjaergaard, H. (2011). Sports and leisure time physical activity during pregnancy in nulliparous women. Maternal Child Health Journal, 15(6), 806-813. doi: 10.1007/s10995-010-0647-y

Jackson, D. J., Batiste, E., & Rendall-Mkosi, K. (2007). Effect of smoking and alcohol use during pregnancy on the occurrence of low birth weight in a farming region in South Africa. Pediatric and Perinatal Epidemiology, 21(5), 432-440. doi: 10.1111/j.1365-3016.2007.00847.x

Jackson, M. L., Sztendur, E. M., Diamond, N. T., Byles, J. E., & Bruck, D. (2014). Sleep difficulties and the development of depression and anxiety: a longitudinal study of young Australian women. Archives of Women’s Mental Health, 17(3), 189-198. doi: 10.1007/s00737-014-0417-8

Jarosz, M., Wierzejska, R., & Siuba, M. (2012). Maternal caffeine intake and its effect on pregnancy outcomes. European Journal of Obstetrics & Gynecology and Reproductive Biology, 160(2), 156-160. doi: 10.1016/j.ejogrb.2011.11.021

Kaneita, Y., Tomofumi, S., Takemura, S., Suzuki, K., Yokoyama, E., Miyake, T., … Ohida, T. (2007). Prevalence of smoking and associated factors among pregnant women in Japan. Preventive Medicine, 45(1), 15-20. doi: 10.1016/j.ypmed.2007.04.009

Kendall, A., Olson, C. M., & Frongillo, E. A. (2001). Evaluation of psychosocial measures for understanding weight-related behaviors in pregnant women. Annals of Behavior Medicine, 23, 50-58. doi: 10.1207/S15324796ABM2301_8

Lawrence, E., Cobb, R. J., Rothman, A. D., Rothman, M. T., & Bradbury, T. N. (2008). Marital satisfaction across the transition to parenthood. Journal of Family Psychology, 22(1), 41-50. doi: 10.1037/0893-3200.22.1.41

Lee, K. A., & Gay, C. L. (2004). Sleep in late pregnancy predicts length of labor and type of delivery. American Journal of Obstetrics and Gynecology, 191(6), 2041-2046. doi: 10.1016/j.ajog.2004.05.086

Leiferman, J. A., & Evenson, K. R. (2003). The effect of regular leisure physical activity on birth outcomes. Maternal and Child Health Journal, 7(1), 59-64. doi: 10.1023/A:1022545718786

Lewis, B. A., & Kennedy, B. F. (2011). Effects of exercise on depression during pregnancy and postpartum: A review. American Journal of Lifestyle Medicine, 5(4), 370-378. doi: 10.1177/1559827610392891

Lindgren, K. (2001). Relationships among maternal-fetal attachment, prenatal depression, and health practices in pregnancy. Research in Nursing & Health, 24(3), 203-217. doi: 10.1002/nur.1023

Liu, J., Laditka, J. N., Mayer-Davis, E. J., & Pate, R. R. (2008). Does physical activity during pregnancy reduce the risk of gestational diabetes among previously inactive women? Birth, 35(3), 188-195. doi: 10.1111/j.1523-536X.2008.00239.x

Lu, Y., Tong, S., & Oldenburg, B. (2001). Determinants of smoking and cessation during and after pregnancy. Health Promotion International, 16(4), 355-365. doi: 10.1093/heapro/16.4.355

Macedo, M., & Precioso, J. (2004). Plano global de prevenção do tabagismo do Município de Braga. Revista Portuguesa de Pneumologia, 10(4), 269-285. doi: 10.1016/S0873-2159(15)30587-0

Marquez-Sterling, S., Perry, A. C., Kaplan, T. A., Halberstein, R. A., & Signorile, J. F. (2000). Physical and psychological changes with vigorous exercise in sedentary primigravidae. Medicine & Science in Sports & Exercise, 32(1), 58-62.

McKee, M. D., Cunningham, M., Jankowski, K. R., & Zayas, L. (2001). Health-related functional status in pregnancy: Relationship to depression and social support in a multi-ethnic population. Obstetrics & Gynecology, 97(6), 988-993.

Miller, R. B., Hollist, C. S., Olsen, J., & Law, D. (2013). Marital quality and health over 20 years: A growth curve analysis. Journal of Marriage and Family, 75(3), 667-680. doi: 10.1111/jomf.12025

Milosevic-Djordjevic, O., Grujicic, D., Arenijevic, S., Brkic, M., Ugrinovic, S., Markinkovic, D. (2007). Micronuclei in cord blood lymphocytes as a biomarker of transplacental exposure to environmental pollutants. Tohoku Journal of Experimental Medicine, 213(3), 231-239. doi: 10.1620/tjem.213.231

Moura-Ramos, M. (2006). Adaptação materna e paterna ao nascimento de um filho: Percursos e contextos de influência (Unpublished master thesis). University of Coimbra, Coimbra.

Mudd, L. M., Pivarnik, J. M., Pfeiffer, K. A., Paneth, N., Chung, H., & Holzman, C. (2015). Maternal physical activity during pregnancy, child leisure-time activity, and child weight status at 3 to 9 years. Journal of Physical Activity & Health, 12(4), 506-514. doi: 10.1123/jpah.2013-0173

Nascimento, S. L., Surita, F. G., & Cecatti, J. G. (2012). Physical exercise during pregnancy: A systematic review. Current Opinion in Obstetrics & Gynecology, 24(6), 387-394. doi: 10.1097/GCO.0b013e328359f131

Nulman, I., Rovet, J., Kennedy, D., Wasson, C., Gladstone, J., Fried, S., & Koren, G. (2004). Binge alcohol consumption by non-alcohol – dependent women during pregnancy affects child behaviour, but not general intellectual functioning: A prospective controlled study. Archives of Women’s Mental Health, 7(3), 173-181. doi: 10.1007/s00737-004-0055-7

O’Keeffe, L. M., Kearney, P. M., Greene, R. A., Zuccolo, L., Tilling, K., Lawlor, D. A., & Howe, L. D. (2015). Maternal alcohol use during pregnancy and offspring trajectories of height and weight: A prospective cohort study. Drug and Alcohol Dependence, 153, 323-329. doi: 10.1016/j.drugalcdep.2015.02.035

Öhman, S. G., Grunewald, C., & Waldenström, U. (2003). Women’s worries during pregnancy: Testing the Cambridge Worry Scale on 200 Swedish women. Scandinavian Journal of Caring Sciences, 17(2), 148-152. doi: 10.1046/j.1471-6712.2003.00095.x

Okun, M. L., Kline, C. E., Roberts, J. M., Wettlaufer, B., Glover, K., & Hall, M. (2013). Prevalence of sleep deficiency in early gestation and its associations with stress and depressive symptoms. Journal of Women’s Health, 22(12), 1028-1037. doi: 10.1089/jwh.2013.4331

Orr, S. T., Blazer, D. G., James, S. A., & Reiter, J. P. (2007). Depressive symptoms and indicators of maternal health status during pregnancy. Journal of Women’s Health, 16(4), 535-542. doi: 10.1089/jwh.2006.0116

Palagini, L., Gemignani, A., Banti, S., Manconi, M., Mauri, M., & Riemann, D. (2014). Chronic sleep loss during pregnancy as a determinant of stress: Impact on pregnancy outcome. Sleep Medicine, 15(8), 853-859. doi: 10.1016/j.sleep.2014.02.013

Pereira, M. A., Rifas-Shiman, S. L., Kleinman, K. P., Rich-Edwards, J. W., Peterson, K. E., & Gilman, M. W. (2007). Predictors of change in physical activity during and after pregnancy: Project Viva. American Journal of Preventive Medicine, 32(4), 312-319. doi: 10.1016/j.amepre.2006.12.017

Petrella, E., Facchinetti, F., Bertarini, V., Pignatti, L., Neri, I., & Battistini, N. C. (2013). Occurrence of pregnancy complications in women with BMI >25 submitted to a healthy lifestyle and eating habits program. American Journal of Obstetrics and Gynecology, 208(S33-S34). doi: 10.1016/j.ajog.2012.10.229

Pottinger, A. M., Trotman Edwards, H., & Younger, N. (2009). Detecting depression during pregnancy and associated lifestyle practices and concerns among women in a hospital-based obstetric clinic in Jamaica. General Hospital Psychiatry, 31(3), 254-261. doi: 10.1016/j.genhosppsych.2009.02.002

Poudevigne, M. S., & O’Connor, P. J. (2006). A review of physical activity patterns in pregnant women and their relationship to psychological health. Sports Medicine, 36(1), 19-38. doi: 10.2165/00007256-200636010-00003

Ramlau-Hansen, C. H., Thulstrup, A. M., Bonde, J. P., Olsen, J., & Bech, B. H. (2008). Semen quality according to prenatal coffee and present caffeine exposure: Two decades of follow-up of a pregnancy cohort. Human Reproduction, 23(12), 2799-2805. doi: 10.1093/humrep/den331

Riman, T., Dickman, P. W., Nilsson, S., Nordlinder, H., Magnusson, C. M., & Persson, I. R. (2004). Some life-style factors and the risk of invasive epithelial ovarian cancer in Swedish women. European Journal of Epidemiology, 19(11), 1011-1019. doi: 10.1007/s10654-004-1633-8

Ross, L. E., & McLean, L. M. (2006). Anxiety disorders during pregnancy and the postpartum period: A systematic review. Journal of Clinical Psychiatry, 67(8), 1285-1298.

Saftlas, A. F., Sackett, N. L., Wang, W., Woolson, R., & Bracken, M. B. (2004). Work, leisure-time physical activity, and risk of preeclampsia and gestational hypertension. American Journal of Epidemiology, 160(8), 758-765. doi: 10.1093/aje/kwh277

Shankaran, S., Das, A., Bauer, C. R., Bada, H. S., Lester, B., Wright, L. L., & Smeriglio, V. (2004). Association between patterns of maternal substance use and infant birth weight, length, and head circumference. Pediatrics, 114(2), 226-234. doi: 10.1542/peds.114.2.e226

Shankaran, S., Lester, B. M., Das, A., Bauer, C. R., Bada, H. S., Lagasse, L., & Higgins, R. (2007). Impact of maternal substance use during pregnancy on childhood outcomes. Seminars in Fetal and Neonatal Medicine, 12(2), 143-150. doi: 10.1016/j.siny.2007.01.002

Silva, L. A., Nakano, A. S., Gomes, F. A., & Stefanello, J. (2009). Significados atribuídos por puérperas adolescentes à maternidade: autocuidado e cuidado com o bebê. Texto Contexto Enferm, Florianópolis, 18(1), 48-56. doi: 10.1590/S0104-07072009000100006

Skouteris, H., Germano, C., Wertheim, E. H., Paxton, S. J., & Milgrom, J. (2008). Sleep quality and depression during pregnancy: A prospective study. Journal of Sleep Research, 17(2), 217-220. doi: 10.1111/j.1365-2869.2008.00655.x

Smedberg, J., Lupattelli, A., Mardby, A., Overland, S., & Nordeng, H. (2015). The relationship between maternal depression and smoking cessation during pregnancy - A cross-sectional study of pregnant women from 15 European countries. Archives of Women’s Mental Health, 18(1), 73-84. doi: 10.1007/s00737-014-0470-3

Smith, L. M., LaGasse, L. L., Derauf, C., Gran, P., Shah, R., Arria, A., … Lester, B. M. (2008). Prenatal methamphetamine use and neonatal behaviour outcome. Neurotoxicology and Teratology, 30(1), 20-28. doi: 10.1016/j.ntt.2007.09.005

Sorensen, T. K., Williams, M. A., Lee, I., Dashow, E. E., Thompson, M. L., & Luthy, D. A. (2003). Recreational physical activity during pregnancy and risk of preeclampsia. Hypertension, 41(6), 1273-1280. doi: 10.1161/01.HYP.0000072270.82815.91

Spanier, G. B. (1976). Measuring dyadic adjustment: New scales for assessing the quality of marriage and similar dyads. Journal of Marriage and Family, 38(1), 15-28. doi: 10.2307/350547

Stelmach, W., Kaczmarczyk-Chalas, K., Bielecki, W., & Drygas, W. (2005). How education, income, control over life and life style contribute to risk factors for cardiovascular disease among adults in a post-communist country. Public Health, 119(6), 498-508. doi: 10.1016/j.puhe.2004.09.006

Tendais, I., Figueiredo, B., Mota, J., & Conde, A. (2011). Physical activity, health-related quality of life and depression during pregnancy. Cadernos de Saúde Pública, 27(2), 219-228. doi: 10.1590/S0102-311X2011000200003

Tenore, G., Daglia, M., Orlando, V., Urso, E., Hassan Saadat, S., Novellino, E., … Mohammad Nabavi, S. (2015). Coffee and depression: A short review of literature. Current Pharmaceutical Design, 21(34), 5034-5040. doi: 10.2174/1381612821666150825145112

Twenge, J. M., Campbell, W. K., & Foster, C. A. (2003). Parenthood and marital satisfaction: A meta-analytic review. Journal of Marriage and Family, 65(3), 574-583. doi: 10.1111/j.1741-3737.2003.00574.x

van Gelder, M. M., Reefhuis, J., Caton, A. R., Werler, M. M., Druschel, C. M., & Roeleveld, N. (2009). Maternal periconceptional illicit drug use and the risk of congenital malformations. Epidemiology, 20(1), 60-66. doi: 10.1097/EDE.0b013e31818e5930

Wallace, P., & Gotlib, I. A. (1990). Marital adjustment during the transition to parenthood: Stability and predictors of change. Journal of Marriage and the Family, 52(1), 21-29. doi: 10.2307/352834

Wedel, H. E., Wall, M. L., & Maftum, M. A. (2008). Sentimentos da mulher na transição gestação-puerpério. Nursing, 11(126), 501-506.

Weng, X., Odouli, R., & Li, D. (2008). Maternal caffeine consumption during pregnancy and the risk of miscarriage: A prospective cohort study. American Journal of Obstetrics and Gynecology, 198(3), 279.e1-279.e8. doi: 10.1016/j.ajog.2007.10.803

Whitworth, M., & Dowswell, T. (2009). Routine pre-pregnancy health promotion for improving pregnancy outcomes. Cochrane Database of Systematic Reviews, 4, CD007536. doi: 10.1002/14651858.CD007536.pub2

Wisborg, K., Kesmodel, U., Bech, B. H., Hedegaard, M., & Henriksen, T. B. (2002). Maternal consumption of coffee during pregnancy and stillbirth and infant death in first year of life: Prospective study. BMJ, 326, 1-4. doi: 10.1136/bmj.326.7386.420

World Health Organization (1998). Health promotion glossary. Genebra. Retrieved May 15th, 2016, from http://www.who.int/healthpromotion/about/HPR%20Glossary%201998.pdf

World Health Organization (2010). Trabajando con individuos, familias y comunidades para mejorar la salud materna y neonatal. Retrieved May 15th, 2016, from http://whqlibdoc.who.int/hq/2010/WHO_MPS_09.06_spa.pdf

Zhang, C., Solomon, C. G., Manson, J. E., & Hu, F. B. (2006). A prospective study of pregravid physical activity and sedentary behaviors in relation to the risk for gestational diabetes mellitus. Archives of Internal Medicine, 166(5), 543-548. doi: 10.1001/archinte.166.5.543

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2018-07-01

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Levandowski, D. C., Pereira, M., Moura­‑Ramos, M., & Canavarro, M. C. (2018). Impacto do estilo de vida na adaptação individual e relacional e nos resultados obstétricos de mulheres adultas após o parto. Psychologica, 61(2), 93-119. https://doi.org/10.14195/1647-8606_61-2_5

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