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Risk of major adverse perinatal outcomes in women with eating disorders

Department of Child and Adolescent Psychiatry and Eating Disorders Research Unit, Institute of Psychiatry, King's College London

Emily Simonoff, MD, FRCPsych

Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London

Janet Treasure, PhD, FRCP, FRCPsych

Eating Disorders Research Unit, Department of Academic Psychiatry (Guy's Hospital), King's College London and ALSPAC, Department of Pediatric and Perinatal Epidemiology, University of Bristol, Bristol, UK

Correspondence: Dr Nadia Micali, Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, Box 085, De Crespigny Park, London SE5 8AF, UK. Email: N.Micali{at}iop.kcl.ac.uk

Declaration of interest None.

Funding detailed in Acknowledgements.

Background Low birth weight, prematurity and higher miscarriage rates have previously been reported in women with eating disorders.

Aims To determine whether women with a history of eating disorders are at higher risk of major adverse perinatal outcomes.

Methods Adjusted birth weight, preterm delivery and miscarriage history were compared in those with a history of eating disorders (anorexia nervosa (n=171), bulimia nervosa (n=199) and both (n=82)) and those with other (n=1166) and no psychiatric disorders (n=10 636) in a longitudinal cohort study.

Results The group with bulimia nervosa had significantly higher rates of past miscarriages (relative risk ratio 2.0, P=0.01) and the group with anorexia nervosa delivered babies of significantly lower birth weightthan the general population (P=0.01), which was mainly explained by lower pre-pregnancy body massindex. Preterm delivery rates were comparable across groups.

Conclusions Women with a history of eating disorders are at higher riskof major adverse obstetric outcomes. Antenatal services should be aware of this higher risk.

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