Pregnancy Complications and Neonatal Outcomes in Women With Eating Disorders

• Published in: The American journal of psychiatry Vol. 158; no. 9; pp. 1461 - 1466
• Main Authors: Franko, Debra L., Blais, Mark A., Becker, Anne E., Delinsky, Sherrie Selwyn, Greenwood, Dara N., Flores, Andrea T., Ekeblad, Elizabeth R., Eddy, Kamryn T., Herzog, David B.
• Format: Journal Article
• Language: English
• Published: Washington, DC American Psychiatric Publishing 01-09-2001; American Psychiatric Association
• Subjects: Adult; Adult and adolescent clinical studies; Anorexia nervosa; Anorexia Nervosa - diagnosis; Anorexia Nervosa - epidemiology; Apgar Score; Biological and medical sciences; Birth Weight; Bulimia; Bulimia - diagnosis; Bulimia - epidemiology; Cesarean Section - statistics & numerical data; Comorbidity; Congenital Abnormalities - diagnosis; Congenital Abnormalities - epidemiology; Depression, Postpartum - diagnosis; Depression, Postpartum - epidemiology; Eating behavior disorders; Eating disorders; Feeding and Eating Disorders - diagnosis; Feeding and Eating Disorders - epidemiology; Female; Follow-Up Studies; Humans; Medical sciences; Newborn babies; Obstetric Labor Complications - diagnosis; Obstetric Labor Complications - epidemiology; Outcomes; Pregnancy; Pregnancy Complications - diagnosis; Pregnancy Complications - epidemiology; Pregnancy Outcome - epidemiology; Pregnant women; Prospective Studies; Psychiatric Status Rating Scales - statistics & numerical data; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Risk Factors; Severity of Illness Index; Mood disorder; Human; Pregnancy disorders; Depression; Anorexia nervosa; Eating disorder; Puerperium; Bulimia; Newborn diseases; Risk factor; Delivery disorders; Complication; Female; Cesarean section
• ISSN: 0002-953X; 1535-7228
• DOI: 10.1176/appi.ajp.158.9.1461

OBJECTIVE: This study reported pregnancy complications and neonatal outcomes for 49 live births in a group of women with eating disorders who were prospectively followed. METHOD: Subjects were recruited from 246 women participating in a longitudinal study of anorexia nervosa and bulimia nervosa, now in its 12th year. Subjects were interviewed by trained assistants and completed a brief self-report instrument that assessed both birth statistics and birth-related complications. Medical records and or self-report data describing the neonates' birth status were obtained. RESULTS: The majority of the women with eating disorders had normal pregnancies, resulting in healthy babies. Across the group, the mean length of pregnancy was 38.7 weeks, the mean birth weight was 7.6 lb, and mean Apgar scores at 1 and 5 minutes after birth were 8.2 and 9.0, respectively. Most outcomes were positive; however, three babies (6.1%) had birth defects, and 17 (34.7%) of the women experienced postpartum depression. The mean number of obstetric complications in the group was 1.3, and 13 (26.5%) of the women delivered by cesarean section. Women who showed symptoms of either anorexia nervosa or bulimia nervosa during pregnancy had a higher frequency of birth by cesarean section and postpartum depression than did nonsymptomatic women. CONCLUSIONS: Pregnant women with active eating disorders appear to be at greater risk for delivery by cesarean section and for postpartum depression. Pregnant women with past or current eating disorders should be viewed as being at high risk and monitored closely both during and after pregnancy to optimize maternal and fetal outcomes.