Conti J, Abraham S, Taylor A
Department of Nutrition and Dietetics, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
J Psychosom Res. 1998 Mar-Apr;44(3-4):465-77. doi: 10.1016/s0022-3999(97)00271-7.
The association between clinical eating disorders, maternal body weight, shape, and eating concerns, and the birth of low-birth-weight infants (LBW; less than 2500 g) was investigated using a retrospective case-control study. Eighty-eight women delivering LBW infants were interviewed and then divided into two groups--those delivering term, small-for-gestational-age infants (SGA; 37 or more completed weeks, n = 34) and those delivering premature infants (less than 37 completed weeks, n = 54). There were 86 reference women (CTRL) matched for age, parity, and health insurance status, who delivered babies with birth weights greater than 2500 g. In the week postpartum, women delivering term SGA, premature (PREM), and CTRL infants were interviewed using a semistructured interview. One section of this interview included a modified version of the Eating Disorder Examination (EDE), which retrospectively generated, over the previous 12 months, diagnosis of an eating disorder and maternal "normative" weight and shape concerns. In the 3 months before pregnancy, 32% of SGA women, 9% PREM women, and 5% of reference women were diagnosed as having a clinical eating disorder. Women with a past history of an eating disorder had no greater risk of delivering a low-birth-weight infant. Women delivering SGA infants, reported elevated eating disorder psychopathology postdelivery (Eating Disorders Inventory, EDI) and more disturbances in eating behavior before and during pregnancy. Unique predictors for delivery of a LBW term SGA infant were: low maternal prepregnancy body weight, smoking, low maternal weekly weight gain, and elevated EDI (Bulimia subscale). Unique predictors for delivery of a LBW premature infant were: lower maternal occupational status, vomiting in pregnancy, and lower dietary restraint. Women with disordered eating were shown to be at greater risk of delivering term SGA infants. Predictors of term growth retardation are partly determined by maternal behavior.
采用回顾性病例对照研究，调查临床饮食失调、母亲体重、体型和饮食担忧与低体重儿（LBW；小于2500克）出生之间的关联。对88名分娩低体重儿的女性进行了访谈，然后将她们分为两组——分娩足月小于胎龄儿（SGA；37周或以上，n = 34）的女性和分娩早产儿（小于37周，n = 54）的女性。有86名对照女性（CTRL），她们在年龄、产次和健康保险状况方面相匹配，所分娩婴儿的出生体重超过2500克。在产后一周，采用半结构化访谈对分娩足月SGA、早产（PREM）和对照婴儿的女性进行了访谈。该访谈的一个部分包括饮食失调检查（EDE）的修改版本，该版本回顾性地生成了过去12个月内饮食失调的诊断以及母亲“正常”的体重和体型担忧。在怀孕前3个月，32%的SGA女性、9%的PREM女性和5%的对照女性被诊断为患有临床饮食失调。有饮食失调病史的女性分娩低体重儿的风险并不更高。分娩SGA婴儿的女性在产后报告饮食失调心理病理学升高（饮食失调问卷，EDI），并且在怀孕前和怀孕期间饮食行为有更多紊乱。分娩足月SGA低体重儿的独特预测因素是：母亲孕前体重低、吸烟、母亲每周体重增加低以及EDI（贪食亚量表）升高。分娩早产低体重儿的独特预测因素是：母亲职业地位较低、孕期呕吐以及饮食抑制较低。饮食紊乱的女性被证明分娩足月SGA婴儿的风险更大。足月生长迟缓的预测因素部分由母亲行为决定。
