Linna Milla S, Raevuori Anu, Haukka Jari, Suvisaari Jaana M, Suokas Jaana T, Gissler Mika
Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland.
Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland; Department of Adolescent Psychiatry, Helsinki University Central Hospital, Helsinki, Finland; Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland; Institute of Clinical Medicine, Child Psychiatry, University of Turku, Turku, Finland.
Am J Obstet Gynecol. 2014 Oct;211(4):392.e1-8. doi: 10.1016/j.ajog.2014.03.067. Epub 2014 Apr 3.
The purpose of this study was to assess pregnancy, obstetric, and perinatal health outcomes and complications in women with lifetime eating disorders.
Female patients (n = 2257) who were treated at the Eating Disorder Clinic of Helsinki University Central Hospital from 1995-2010 were compared with unexposed women from the population (n = 9028). Register-based information on pregnancy, obstetric, and perinatal health outcomes and complications were acquired for all singleton births during the follow-up period among women with broad anorexia nervosa (AN; n = 302 births), broad bulimia nervosa (BN; n = 724), binge eating disorder (BED; n = 52), and unexposed women (n = 6319).
Women with AN and BN gave birth to babies with lower birthweight compared with unexposed women, but the opposite was observed in women with BED. Maternal AN was related to anemia, slow fetal growth, premature contractions, short duration of the first stage of labor, very premature birth, small for gestational age, low birthweight, and perinatal death. Increased odds of premature contractions, resuscitation of the neonate, and very low Apgar score at 1 minute were observed in mothers with BN. BED was associated positively with maternal hypertension, long duration of the first and second stage of labor, and birth of large-for-gestational-age infants.
Eating disorders appear to be associated with several adverse perinatal outcomes, particularly in offspring. We recommend close monitoring of pregnant women with either a past or current eating disorder. Attention should be paid to children who are born to these mothers.
本研究旨在评估患有终身性饮食失调症的女性的妊娠、产科及围产期健康结局和并发症。
将1995年至2010年在赫尔辛基大学中心医院饮食失调诊所接受治疗的女性患者（n = 2257）与来自普通人群的未暴露女性（n = 9028）进行比较。在随访期间，获取了患有广泛性神经性厌食症（AN；n = 302例分娩）、广泛性神经性贪食症（BN；n = 724例）、暴饮暴食症（BED；n = 52例）的女性以及未暴露女性（n = 6319例）所有单胎分娩的基于登记的妊娠、产科及围产期健康结局和并发症信息。
与未暴露女性相比，患有AN和BN的女性所生婴儿出生体重较低，但患有BED的女性情况则相反。母亲患AN与贫血、胎儿生长缓慢、早产宫缩、第一产程时间短、极早产、小于胎龄、低出生体重及围产期死亡有关。患有BN的母亲出现早产宫缩、新生儿复苏及1分钟时阿氏评分极低的几率增加。BED与母亲高血压、第一和第二产程时间长以及大于胎龄儿出生呈正相关。
饮食失调似乎与多种不良围产期结局相关，尤其是对后代。我们建议对有既往或当前饮食失调症的孕妇进行密切监测。应关注这些母亲所生的孩子。
