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Pregnancy and Neonatal Outcomes in Women With Eating Disorders

Saloua Kouba, CNM^*, Tore Hällström, MD, PhD, Caroline Lindholm, MD, PhD^* and Angelica Lindén Hirschberg, MD, PhD^*

From the *Department of Obstetrics and Gynecology, Karolinska University Hospital, and Neurotec Department, Section of Psychiatry, Karolinska Institute, Stockholm, Sweden.

Address reprint requests to: Angelica Lindén Hirschberg, MD, PhD, Department of Obstetrics and Gynecology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden; e-mail: angelica.linden-hirschberg{at}kus.se.

OBJECTIVE: This study was initiated to examine pregnancy and neonatal outcomes in women with past or current eating disorders as compared with a control group.

METHODS: Forty-nine nulliparous nonsmoking women previously diagnosed with eating disorders (24 anorexia nervosa, 20 bulimia nervosa, 5 eating disorders not otherwise specified) and 68 controls were recruited in early pregnancy. Data on antenatal complications, mode of delivery, and neonatal outcome variables were collected. For comparisons between groups 1-way analysis of variance or ² test was used.

RESULTS: Twenty-two percent of the patients had a verified relapse in eating disorders during pregnancy. Women with past or current eating disorders were at increased risk of hyperemesis (P < .01) and delivered infants with significantly lower birth weight (P < .01) and smaller head circumference (P < .001) as compared with controls. They were also at greater risk of delivering infants with microcephaly (P < .05) and small for gestational age infants (P < .05).

CONCLUSION: Pregnant women with past or active eating disorders seem to be at greater risk for delivering infants with lower birth weight, smaller head circumference, microcephaly, and small for gestational age.

LEVEL OF EVIDENCE: II-2

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