Morrill E S, Nickols-Richardson H M
Department of Human Nutrition, Foods and Exercise, 225 Wallace Hall, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061-0430, USA.
J Am Diet Assoc. 2001 Apr;101(4):448-54. doi: 10.1016/S0002-8223(01)00115-8.
Pregnant women with bulimia nervosa present interesting practice challenges for dietitians and healthcare professionals due to potential complications of bulimia nervosa for both mothers and fetuses. This review summarizes case study reports, case series reports, and retrospective studies of women with bulimia nervosa during pregnancy, and focuses on relationships among bulimic behaviors, pregnancy results, and birth outcomes. Pregnancy and birth outcomes of women with bulimia nervosa varied among individuals and studies. Material outcomes of concern included miscarriages, inappropriate weight gains (excessive or inadequate), complicated deliveries, and resumed and/or continued bulimic behaviors shortly after parturition. Fetal complications included low birth weights, prematurity, malformations, and low Apgar scores. Screening to detect bulimic behaviors is recommended, as is multidisciplinary treatment of pregnant women with bulimia nervosa to emphasize adequate dietary intakes, promote appropriate weight gains, and help achieve healthy infant outcomes in addition to long-term, healthy eating habits for these women. Future research regarding maternal and fetal outcomes of women with bulimia nervosa during pregnancy, conducted by registered dietitians, is needed to provide greater clarity and understanding of the impact of bulimic behaviors, dietary intakes, and nutritional status during pregnancy on maternal and fetal health.
由于神经性贪食症对母亲和胎儿都有潜在并发症，患有神经性贪食症的孕妇给营养师和医疗保健专业人员带来了有趣的实践挑战。本综述总结了孕期患有神经性贪食症女性的病例研究报告、病例系列报告和回顾性研究，并重点关注贪食行为、妊娠结果和分娩结局之间的关系。患有神经性贪食症女性的妊娠和分娩结局在个体和研究中各不相同。值得关注的母体结局包括流产、体重增加不当（过多或不足）、分娩并发症以及产后不久恢复和/或持续的贪食行为。胎儿并发症包括低出生体重、早产、畸形和低阿氏评分。建议进行筛查以检测贪食行为，对患有神经性贪食症的孕妇进行多学科治疗，以强调充足的饮食摄入、促进适当的体重增加，并帮助实现健康的婴儿结局，此外还要帮助这些女性养成长期健康的饮食习惯。需要注册营养师对孕期患有神经性贪食症女性的母婴结局进行未来研究，以更清楚地了解孕期贪食行为、饮食摄入和营养状况对母婴健康的影响。
