Morgan John F, Lacey J Hubert, Chung Elaine
Department of Mental Health, St George's Hospital Medical School, London, United Kingdom.
Psychosom Med. 2006 May-Jun;68(3):487-92. doi: 10.1097/01.psy.0000221265.43407.89.
Bulimia nervosa is common and treatable. An association between bulimia and obstetric complications has been suggested, but sample size and absence of control have limited previous studies. Our aim was to determine if active bulimia nervosa affects obstetric outcome.
This was a retrospective case-control comparison of obstetric complications in primigravidae previously treated for bulimia in a specialist eating disorder service. A cohort of 122 women with active bulimia during pregnancy was contrasted against 82 with quiescent bulimia, using structured interviews comprising the Eating Disorders Examination, Structured Clinical Interview for DSM-III-R, and systematic questions addressing obstetric complications.
Odds ratios (ORs) for postnatal depression, miscarriage, and preterm delivery were 2.8 (95% confidence interval [CI], 1.2-6.2), 2.6 (95% CI, 1.2-5.6) and 3.3 (95% CI, 1.3-8.8) respectively. Risk of unplanned pregnancy was markedly elevated (OR, 30.0; 95% CI, 12.8-68.7). Risk estimates were not explained by differences in adiposity, demographics, alcohol/substance/laxative misuse, smoking, or year of birth, but relative contributions of bulimic behaviors were not discerned.
Active bulimia during pregnancy is associated with postnatal depression, miscarriage, and preterm delivery. Bulimia may be a treatable cause of adverse obstetric outcome.
神经性贪食症很常见且可治疗。有人提出贪食症与产科并发症之间存在关联，但样本量和缺乏对照限制了以往的研究。我们的目的是确定活跃的神经性贪食症是否会影响产科结局。
这是一项对在专科饮食失调服务机构接受过贪食症治疗的初产妇产科并发症进行的回顾性病例对照比较研究。使用包括饮食失调检查、DSM-III-R结构化临床访谈以及关于产科并发症的系统性问题的结构化访谈，将122名孕期患有活跃性贪食症的女性队列与82名患有静止性贪食症的女性进行对比。
产后抑郁、流产和早产的比值比（OR）分别为2.8（95%置信区间[CI]，1.2 - 6.2）、2.6（95%CI，1.2 - 5.6）和3.3（95%CI，1.3 - 8.8）。意外怀孕的风险显著升高（OR，30.0；95%CI，12.8 - 68.7）。风险估计不能用肥胖、人口统计学、酒精/物质/泻药滥用、吸烟或出生年份的差异来解释，但未明确贪食行为的相对影响。
孕期活跃性贪食症与产后抑郁、流产和早产有关。贪食症可能是不良产科结局的一个可治疗原因。
