Revista de Medicina Desportiva (English) November 2018 | Page 9
female athlete. The preservation of
the bone mass is especially impor-
tant during adolescence and at the
onset of the adulthood. It is very
important to identify the first year
of amenorrhea of the athletes, since
the loss of bone mass is more active
during this period. The criteria for
diagnosis of osteoporosis in children
is the z-score, associated to the clini-
cal risk factors.
The athletes have more chance to
develop eating disorders than the
general population and this kind of
problem can arise in any athlete.
The low energetic intake and the
eating disorders occur as a spec-
trum, this is, from a not intentional
low intake to calorie, protein and/
or fat restriction and pathological
behaviors of weight control to the
classical diseases of food behavior.
In this kind of situations, the pri-
mary prevention is the main objec-
tive.
Menstrual dysfunction is a t
least 2 to 3 times more frequent in
the athletes than in the no-athlete
women, where the athlete is at risk
of primary or secondary amenor-
rhea. The intense exercise doesn’t
necessarily cause menstrual dys-
function provided there is enough
energetic intake. The female athlete
triad is a medical condition that
involves three interrelated compo-
nents: low energetic intake (with or
without eating disorders), menstrual
dysfunction, and low bone mineral
density, which obliges the interven-
tion of a multidisciplinary team.
Physical exercise during pregnancy
is in general safe, although there are
some risks: environmental exposure,
dehydration, hypoxia and uterine
trauma. The intra uterine device is
an accepted method for contracep-
tion for the athletes.
In this test of mine there were sev-
eral important aspects not referred
in relation to the 10 situations that
were analyzed in the paper. A care-
ful reading is highly advised – it is
consensus statement.
1. Female Athlete Issues for the Team
Physician: A Consensus Statement –
2017 Update. Med Sci Sports Exerc. 2018
May;50(5):1113-1122.
PÓS-GRADUAÇÕES
FORMAÇÃO CONTÍNUA
Dra. Maria João Dias
Coutinho Martins,
Resident doctor of
Medical General
Practitioner USF,
Freamunde a
ENSINO
PRESENCIAL
OU À DISTÂNCIA
Physical activity and the risk
of preterm birth: a systematic
review and meta-analysis of
epidemiological studies, 2017 1
The pattern of physical activity for
the population in general is still
below of the desired, but, however,
is keeping growing the population’s
concern to seek a healthy life style.
Increasingly it is observed the crea-
tion of social currents that stimu-
late a healthy diet and the increase
of the physical activity. Pregnant
women show superior patterns of
inactivity, where the counseling in
this field is quite often determined
by cultural influences, more than
by scientific evidence. However,
the importance of counselling has
grown up, especially by showing the
information from recent scientific
studies about the several benefits of
physical exercise during this period
of life of the pregnant woman.
In despite of intense scientific
evolution in this filed, the association
between physical activity and the
risk of preterm delivery (PTD) keep
inconsistent results in the studies,
some point to an inverse relationship,
while others didn’t find any signifi-
cative association. This systematic
review come as a try to clarify this
relationship, and the authors have
the private interest in clarifying the
existence of dose-response for the
activity, the potential confounders
and other characteristics that are
responsible for the heterogeneity of
the results previous published.
In the paper, PTD is defined as the
delivery before 37 complete weeks
of gestation, which is responsible for
about 23% of deaths of 3,6 million
of neonatal deaths in the world,
and in 2012 there was an estimated
number of 15 million PTD world-
wide. Still, in the same paper, it is
indicated that preterm babies have a
higher risk of cognitive and develop-
ment incapacities.
There are several established
risk factors, like alcohol and smoke
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