患有饮食障碍的母亲的妊娠和产后体重变化模式。
Gestational and postpartum weight change patterns in mothers with eating disorders.
机构信息
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC.
出版信息
Eur Eat Disord Rev. 2014 Nov;22(6):397-404. doi: 10.1002/erv.2314. Epub 2014 Sep 9.
BACKGROUND
Although pregnancy can be associated with adaptive changes in weight and eating behaviour for women with eating disorders, less is known about whether these changes are maintained in the postpartum period. We used a longitudinal design to examine gestational and postpartum weight trajectories in mothers with and without eating disorders in the Norwegian Mother and Child Cohort Study (MoBa) conducted by the Norwegian Institute of Public Health.
METHODS
Fifty-six women reported anorexia nervosa (AN), 636 bulimia nervosa, 3327 binge eating disorder and 69 eating disorder not otherwise specified, purging type. The referent group included 61,233 mothers with no eating disorder. We used a mixed effects model to predict weight change over time by eating disorder subtype.
RESULTS
Mothers with AN, bulimia nervosa, binge eating disorder and eating disorder not otherwise specified had greater increases in body mass index (BMI) during pregnancy and greater decreases in BMI over the first 6 months postpartum. Women with AN shifted from the underweight BMI range before pregnancy to the normal weight range at 36 months postpartum
CONCLUSIONS
Patterns of maternal weight gain and retention during the perinatal period vary across eating disorder subtype and warrant clinical attention.
背景
尽管妊娠可能会导致饮食障碍女性的体重和饮食行为出现适应性变化，但对于这些变化在产后期间是否得到维持知之甚少。我们使用纵向设计，在由挪威公共卫生研究所进行的挪威母亲和儿童队列研究（MoBa）中，检查了患有和不患有饮食障碍的母亲的妊娠期和产后体重轨迹。
方法
56 名女性报告了神经性厌食症（AN），636 名患有贪食症，3327 名患有暴食症，69 名患有未特指的、有排泄行为的饮食障碍。参照组包括 61233 名没有饮食障碍的母亲。我们使用混合效应模型，根据饮食障碍亚型预测体重随时间的变化。
结果
患有 AN、贪食症、暴食症和未特指的、有排泄行为的饮食障碍的母亲在怀孕期间体重指数（BMI）增加更多，产后前 6 个月 BMI 下降更多。患有 AN 的女性在怀孕前体重指数处于消瘦范围，产后 36 个月体重指数转为正常范围。
结论
围产期期间母亲体重增加和保留的模式因饮食障碍亚型而异，值得临床关注。
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