Pregnancy outcomes of women with and without a history of anorexia nervosa

• Published in: Psychological medicine Vol. 42; no. 12; pp. 2651 - 2660
• Main Authors: Eagles, J. M., Lee, A. J., Raja, E. Amalraj, Millar, H. R., Bhattacharya, S.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.12.2012
• Subjects: Adult; Adult and adolescent clinical studies; Anorexia; Anorexia nervosa; Anorexia Nervosa - diagnosis; Anorexia Nervosa - epidemiology; Babies; Biological and medical sciences; Birth Weight; Body Mass Index; Childbirth & labor; Eating behavior disorders; Female; Fetal Growth Retardation - diagnosis; Fetal Growth Retardation - epidemiology; Humans; Infant, Low Birth Weight; Infant, Newborn; Infant, Small for Gestational Age; Medical sciences; Mothers; Original Articles; Pregnancy; Pregnancy Complications - diagnosis; Pregnancy Complications - epidemiology; Pregnancy Outcome; Pregnant women; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Registries; Risk; Risk factors; Scotland; Statistics as Topic; Women; Womens history; Scotland; birth weight; pregnancy outcomes; pregnancy complications; Anorexia nervosa; pregnancy; Pregnancy; Human; Complication; Female; Birth weight; Eating disorder; Woman; History; Comparative study
• ISSN: 0033-2917; 1469-8978
• DOI: 10.1017/S0033291712000414

When women have a history of anorexia nervosa (AN), the advice given about becoming pregnant, and about the management of pregnancies, has usually been cautious. This study compared the pregnancy outcomes of women with and without a history of AN. Women with a confirmed diagnosis of AN who had presented to psychiatric services in North East Scotland from 1965 to 2007 were identified. Those women with a pregnancy recorded in the Aberdeen Maternal and Neonatal Databank (AMND) were each matched by age, parity and year of delivery of their first baby with five women with no history of AN. Maternal and foetal outcomes were compared between these two groups of women. Comparisons were also made between the mothers with a history of AN and all other women in the AMND. A total of 134 women with a history of AN delivered 230 babies and the 670 matched women delivered 1144 babies. Mothers with AN delivered lighter babies but this difference did not persist after adjusting for maternal body mass index (BMI) in early pregnancy. Standardized birthweight (SBW) scores suggested that the AN mothers were more likely to produce babies with intrauterine growth restriction (IUGR) [relative risk (RR) 1.54, 95% confidence interval (CI) 1.11-2.13]. AN mothers were more likely to experience antepartum haemorrhage (RR 1.70, 95% CI 1.09-2.65). Mothers with a history of AN are at increased risk of adverse pregnancy outcomes. The magnitude of these risks is relatively small and should be appraised holistically by psychiatric and obstetric services.