Perinatal Outcomes among Women with Eating Disorders

Lower birth weights, prematurity, and other adverse outcomes, including gestational diabetes, hypertension, and fetal distress, are commonly reported among mothers with a history of an eating disorder. However, as she reported at the International Conference on Eating Disorders in Austin, TX, Dr. Nadia Micali of the University College of London Institute of Child Health, London, had different results in a large multi-ethnic, population-based study. Dr. Micali reported few complications among a large group that included women with a lifetime history of anorexia nervosa (AN; n=129), or bulimia nervosa (BN; n=209), a lifetime combination of both AN and BN (n=100), 1,070 women with a lifetime history of other psychiatric disorders, and 3796 normal controls. Women with BN initially were thought to have 60% higher odds of emergency cesarean section, but this was insignificant after adjustment. There were no differences in Apgar scores or hospitalizations after birth, and no differences in birth weights, prematurity, or in the number of small-for-gestational age infants. When Dr. Micali evaluated gestational weight gain, she found that women with AN had lower weight throughout gestation, but higher weekly weight gains, and women with BN had higher gestational weight throughout but lower weekly weight gains. These gestational weight gain patterns suggest a protective pattern of weight gain during pregnancy, according to Dr. Micali. In another recent study, Eagles et al. found that mothers with a history of AN are at increased risk of adverse pregnancy outcomes. In an article published in Psychological Medicine (vol. 22, March 2012, pp. 1-10), the authors reported that the magnitude of these risks is relatively small and should be appraised holistically by psychiatric and obstetric physicians.