Women with eating disorders are at an increased risk for adverse pregnancy and neonatal outcomes and should thus be recognized as a high-risk population among pregnant women, according to results of a population-based cohort study published in JAMA Psychiatry.
“From a clinical point of view, these findings emphasize the importance of developing a reliable antenatal routine enabling identification of women with ongoing or previous eating disorders and considering extended pregnancy screening,” Ängla Mantel, MD, PhD, of the department of medicine, Solna at the Karolinska Institute in Stockholm, and colleagues wrote.
According to the researchers, although eating disorders are common among women of reproductive age, research into their effects on pregnancy outcomes and neonatal health is sparse. They used data from the Swedish Medical Birth Register for all singleton births in Sweden between 2003 and 2014 to determine the relative risk of adverse pregnancy outcomes from eating disorders in this patient population. The database included 1,225,321 women without eating disorders, and the researchers compared their outcomes to those of 7,542 women with eating disorders.
Mantel and colleagues found that all subtypes of maternal eating disorders were associated with an approximate doubled risk for hyperemesis during pregnancy. Women with active anorexia nervosa had a doubled risk for anemia. Maternal anorexia nervosa was also associated with an increased risk for antepartum hemorrhage, which was more pronounced in active disease than previous disease. Women with anorexia nervosa and an eating disorder otherwise not specified were at decreased risk for instrumental-assisted vaginal births, which was the only difference in mode of delivery. Further, women with all subtypes of eating disorders were at increased risk for a preterm birth and of delivering neonates with microcephaly.
“Important future research tasks should focus on identifying mechanisms behind the impaired outcomes for women with eating disorders as well as addressing long-term outcomes,” the researchers wrote. – by Joe Gramigna
Disclosures: Mantel reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.