Eating disorders raise risk for problems during pregnancy and in neonates

Takeaway

• Pregnant women with a history of eating disorders had increased risks for hyperemesis and anemia during pregnancy, preterm birth, and delivering infants with microcephaly.

Why this matters

• Women with eating disorders should be considered high risk during pregnancy.

Study design

• Swedish national population-based cohort study on singleton births (2003-2014; n=1,236,777).
• Funding: None disclosed.

Key results

• Eating disorders were associated with increased risks for:
  • hyperemesis
    • anorexia nervosa (AN; n=2769; adjusted risk ratio [aRR], 2.0; 95% CI, 1.7-2.4),
    • bulimia nervosa (BN; n=1378; aRR, 2.0; 95% CI, 1.5-2.5), and
    • eating disorder not otherwise specified (EDNOS; n=3395; aRR, 2.3; 95% CI, 2.0-2.7).
  • preterm birth:
    • AN (aRR, 1.5; 95% CI, 1.3-1.8),
    • BN (aRR, 1.2; 95% CI, 1.0-1.6), and
    • EDNOS (aRR, 1.4; 95% CI, 1.2-1.6).
  • microcephaly:
    • AN (aRR, 1.7; 95% CI, 1.3-2.1),
    • BN (aRR, 1.5; 95% CI, 1.1-2.2), and
    • EDNOS (aRR, 1.3; 95% CI, 1.0-1.7).
  • anemia:
    • active AN (RR, 2.1; 95% CI, 1.3-3.2) and
    • active EDNOS (RR, 2.1; 95% CI, 1.5-2.8).
  • antepartum hemorrhage:
    • AN (aRR, 1.6; 95% CI, 1.2-2.2).
• Decreased risks for instrument-assisted vaginal births were noted in:
  • AN (aRR, 0.7; 95% CI, 0.6-0.8) and
  • EDNOS (aRR, 0.8; 95% CI, 0.7-0.9).

Limitations

• Validity or eating disorders not assessed.

Coauthored with Chitra Ravi, MPharm