Stewart D E
University of Toronto, St. Michael's Hospital, Ontario, Canada.
Ann Med. 1992 Aug;24(4):287-91. doi: 10.3109/07853899209149956.
This article reviews current knowledge about the effects of anorexia nervosa, bulimia nervosa and partial syndromes on ovulation, menstruation, sexuality, fertility, pregnancy and fetal-infant health. Eating disorders may result in failure to ovulate, oligomenorrhea, amenorrhea, reduced sex drive, infertility, hyperemesis gravidarum, low maternal weight gain in pregnancy, small babies for gestational date, low birth weight infants, increased neonatal morbidity and problems in infant feeding. The available information suggests that clinicians should inquire about nutritional intake, a history of eating disorders and weight reducing behaviours as part of the routine assessment of patients with the disorders of reproductive function listed above. If an eating disorder is discovered before conception, the woman should be encouraged to delay pregnancy until the eating disorder is treated and effectively under control. If the woman is pregnant, early diagnosis and treatment are essential to reduce maternal and fetal complications. The infants of eating-disordered women should be carefully followed to ensure adequate nutritional intake. Problems in reproductive function related to eating disorders offer rich opportunities for multispecialty collaboration in primary and secondary prevention programmes directed toward both mother and infant.
本文综述了目前关于神经性厌食症、神经性贪食症及部分综合征对排卵、月经、性功能、生育能力、妊娠及胎儿-婴儿健康影响的相关知识。饮食失调可能导致不排卵、月经过少、闭经、性欲减退、不孕、妊娠剧吐、孕期母亲体重增加不足、小于胎龄儿、低出生体重儿、新生儿发病率增加以及婴儿喂养问题。现有信息表明，临床医生在对上述生殖功能障碍患者进行常规评估时，应询问其营养摄入情况、饮食失调病史及减肥行为。如果在受孕前发现饮食失调，应鼓励女性推迟怀孕，直至饮食失调得到治疗并有效控制。如果女性已怀孕，早期诊断和治疗对于减少母婴并发症至关重要。患有饮食失调症的女性所生婴儿应密切随访，以确保充足的营养摄入。与饮食失调相关的生殖功能问题为针对母婴的一级和二级预防项目中的多专业协作提供了丰富的机会。
