Obstetric and gynecologic problems associated with eating disorders

卷:49

Kimmel, M. C. ; Ferguson, E. H. ; Zerwas, S. ; Bulik, C. M. ; Meltzer-Brody, S.

Univ N Carolina

关键词: obstetrics;    gynecology;    anorexia nervosa;    bulimia nervosa;    binge eating disorder;    perinatal mood disorders;    pregnancy;    postpartum;    fertility;    multidisciplinary;   

DOI  :  10.1002/eat.22483

学科分类：食品科学和技术

【 摘 要 】

ObjectiveThis article summarizes the literature on obstetric and gynecologic complications associated with eating disorders. MethodWe performed a comprehensive search of the current literature on obstetric and gynecologic complications associated with eating disorders using PubMed. More recent randomized-controlled trials and larger data sets received priority. We also chose those that we felt would be the most relevant to providers. ResultsCommon obstetric and gynecologic complications for women with eating disorders include infertility, unplanned pregnancy, miscarriage, poor nutrition during pregnancy, having a baby with small head circumference, postpartum depression and anxiety, sexual dysfunction and complications in the treatment for gynecologic cancers. There are also unique associations by eating disorder diagnosis, such as earlier cessation of breastfeeding in anorexia nervosa; increased polycystic ovarian syndrome in bulimia nervosa; and complications of obesity as a result of binge eating disorder. DiscussionWe focus on possible biological and psychosocial factors underpinning risk for poor obstetric and gynecological outcomes in eating disorders. Understanding these factors may improve both our understanding of the reproductive needs of women with eating disorders and their medical outcomes. We also highlight the importance of building multidisciplinary teams to provide comprehensive care to women with eating disorders during the reproductive years. Resumen ObjetivoEste articulo revisa la literatura acerca de complicaciones Gineco-obstetricas asociadas con trastornos de la conducta alimentaria. MetodoSe realizo una busqueda de la literatura actual acerca de las complicaciones gineco-obstetricas asociadas con trastornos de la conducta alimentaria usando PubMed. Se dio prioridad a los estudios aleatorios controlados mas recientes y grandes bases de datos. Tambien escogimos aquellos que sentimos podrian ser mas relevantes. ResultadosLas complicaciones gineco obstetricas comunes en mujeres con trastornos de la conducta alimentaria incluyen, infertilidad, embarazo no planeado, aborto espontaneo, desnutricion durante el embarazo, tener un bebe con disminucion del tamano de la circunferencia craneal, depresion y ansiedad postparto, disfuncion sexual y complicaciones en el tratamiento de canceres ginecologicos. Hay tambien asociaciones particulares segun el trastorno de la conducta alimentaria como interrupcion temprana de la alimentacion al seno materno en la anorexia nervosa; aumento de sindrome de ovario poliquistico en bulimia nervosa; y complicaciones de obesidad como resultado del trastorno por atracon. DiscusionNos enfocamos en los posibles factores biologicos y psicosociales que refuerzan el riesgo de complicaciones gineco-obstetricas en pacientes con trastorno de la conducta alimentaria. Entender estos factores puede mejorar tanto nuestro entendimiento de las necesidades reproductivas de las mujeres con trastorno de la conducta alimentaria asi como su evolucion medica. Destacamos tambien la importancia de formar equipos multidisciplinarios para proveer un cuidado exhaustivo a las mujeres con trastorno de la conducta alimentaria durante sus anos reproductivos. (c) 2015 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:260-275)