Adolescent and young adult psychiatry unit, Institut Mutualiste Montsouris, 42, boulevard Jourdan, 75014 Paris, France.
Adolescent and young adult psychiatry unit, Institut Mutualiste Montsouris, 42, boulevard Jourdan, 75014 Paris, France.
Ann Endocrinol (Paris). 2022 Jun;83(3):191-195. doi: 10.1016/j.ando.2022.04.012. Epub 2022 Apr 21.
Anorexia nervosa is a psychiatric disorder that mainly affects women (sex ratio 1/10) and for which the prognosis remains poor (10% of deaths and high risk of chronicity). This disorder is associated with a risk of infertility explained by different physiopathological pathways. Thus, the clinical and subclinical forms of this disease may be over-represented in populations of women using medically assisted reproduction technologies. This raises the question of a narcissistic investment of the pregnancy, with a desire for pregnancy for what it brings to the woman. However, this recourse to mechanized care to access motherhood leads to questions for these women for whom access to femininity and sexuality may have been hindered. Furthermore, suffering from eating disorders might have a significant impact upon pregnancy, birth, and the offspring's well-being with psychiatric, obstetric, pediatric, child psychiatric and developmental morbidities. Thus, several specific aspects must be considered by medical professionals when women with anorexia nervosa either intend to undergo fertility treatment or become pregnant. It is important to promote the training of nursing and medical staff to the specific clinic of anorexia nervosa and the development and implementation of multidisciplinary teams to ensure follow-up of these women from the beginning of their treatment until the sixth month postpartum.
神经性厌食症是一种主要影响女性（性别比例为 1/10）的精神障碍，其预后仍然较差（10%的死亡率和高慢性风险）。这种疾病与不孕的风险有关，其发病机制涉及不同的病理生理途径。因此，在使用医学辅助生殖技术的女性人群中，这种疾病的临床和亚临床形式可能更为常见。这就提出了一个问题，即怀孕可能会带来自恋投资，因为怀孕本身会给女性带来好处。然而，这种借助机械手段来获得母性的做法，使得这些女性产生了疑问，因为她们获得女性气质和性的机会可能受到了阻碍。此外，饮食失调可能会对怀孕、分娩和后代的健康产生重大影响，导致精神、产科、儿科、儿童精神科和发育方面的病态。因此，当患有神经性厌食症的女性打算接受生育治疗或怀孕时，医疗专业人员必须考虑几个具体方面。重要的是要促进护理和医务人员对神经性厌食症的具体临床治疗的培训，以及发展和实施多学科团队，以确保从治疗开始到产后第六个月对这些女性进行跟踪。
