The Impact of Bulimia Nervosa on Pregnancy

Active bulimia nervosa (BN) raises the risk of miscarriage, prematurity, and postnatal depression, according to the results of a recent study at St. George’s Hospital, London. Using a retrospective case-control study of women treated between 1988 and 1994, Drs. John F. Morgan and J.H. Lacey compared the course of 122 women with active BN during pregnancy with 82 controls with quiescent BN. Active bulimia nervosa was significantly associated with miscarriage (26% of subjects vs. 12% of controls, preterm delivery (23% in subjects vs. 8% of controls), and possible gestational diabetes (16% in subjects vs. 3 % of controls. All women in the active group were binge eating regularly, and 95% were also inducing vomiting. None of the control patients were inducing vomiting. Although the study did not address the relative contributions of vomiting, binge eating, or extreme restriction of calories on pregnancy, the authors note that it is possible that BN precipitates these complications, for example, through altered insulin sensitivity and the subsequent effect on placental blood flow.The study was reported at the Academy for Eating Disorders annual meeting in New York in May.