Charbonneau Kimberly D, Seabrook Jamie A
a School of Food and Nutritional Sciences, Brescia University College, London, ON.
c Children's Health Research Institute, London, ON.
Can J Diet Pract Res. 2019 Sep 1;80(3):131-136. doi: 10.3148/cjdpr-2018-044. Epub 2019 Feb 7.
At least 5% of women have an eating disorder (ED) during pregnancy. These EDs affect prepregnancy body mass index (BMI) and weight gain during pregnancy, factors associated with birth complications and adverse neonatal outcomes. This review contributes to the literature by examining several adverse birth outcomes associated with EDs and differentiates between past and present EDs. Of the 18 articles reviewed, EDs were associated with preterm birth in 5/14 (36%) and small-for-gestational-age in 5/8 (63%) studies. Anorexia Nervosa increases the odds of a low birth weight baby, particularly when women enter pregnancy with a low BMI. Binge Eating Disorder is positively associated with having a large-for-gestational-age infant, and Bulimia Nervosa is associated with miscarriage when symptomatic during pregnancy. Having a current ED increases the risk for adverse birth outcomes more than a past ED. Since the aetiology of adverse birth outcomes is multi-factorial, drawing conclusions about causal relationships between EDs and birth outcomes is problematic given the small number of studies reporting these outcomes. Resources should target preconception interventions that put EDs into remission and help women achieve a healthier BMI prior to pregnancy, as these have been consistently shown to improve birth outcomes.
至少5%的女性在孕期患有饮食失调症（ED）。这些饮食失调症会影响孕前体重指数（BMI）以及孕期体重增加，而这些因素与分娩并发症和不良新生儿结局相关。本综述通过研究与饮食失调症相关的几种不良分娩结局，并区分过去和现在的饮食失调症，为该领域文献做出了贡献。在所审查的18篇文章中，有5/14（36%）的研究表明饮食失调症与早产有关，5/8（63%）的研究表明与小于胎龄儿有关。神经性厌食症会增加低体重儿的几率，尤其是当女性孕前BMI较低时。暴饮暴食症与大于胎龄儿呈正相关，神经性贪食症在孕期有症状时与流产有关。当前患有饮食失调症比过去患有饮食失调症会增加更多不良分娩结局的风险。由于不良分娩结局的病因是多因素的，鉴于报告这些结局的研究数量较少，因此很难就饮食失调症与分娩结局之间的因果关系得出结论。资源应针对孕前干预措施，使饮食失调症得到缓解，并帮助女性在怀孕前达到更健康的BMI，因为这些措施已被一致证明可改善分娩结局。
