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Pregnancy outcomes of women with and without a history of anorexia nervosa

Published online by Cambridge University Press:  22 March 2012

J. M. Eagles ,
A. J. Lee ,
E. Amalraj Raja ,
H. R. Millar  and
S. Bhattacharya
J. M. Eagles
Affiliation:
Royal Cornhill Hospital, Aberdeen, UK
A. J. Lee
Affiliation:
Division of Applied Health Sciences, University of Aberdeen, UK
E. Amalraj Raja
Affiliation:
Division of Applied Health Sciences, University of Aberdeen, UK
H. R. Millar
Affiliation:
Royal Cornhill Hospital, Aberdeen, UK
S. Bhattacharya*
Affiliation:
Division of Applied Health Sciences, University of Aberdeen, UK
*
*Address for correspondence: Dr S. Bhattacharya, Dugald Baird Centre for Research on Women's Health, Aberdeen Maternity Hospital, Aberdeen AB25 2ZL, UK. (Email: [email protected])
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Abstract

Background

When women have a history of anorexia nervosa (AN), the advice given about becoming pregnant, and about the management of pregnancies, has usually been cautious. This study compared the pregnancy outcomes of women with and without a history of AN.

Method

Women with a confirmed diagnosis of AN who had presented to psychiatric services in North East Scotland from 1965 to 2007 were identified. Those women with a pregnancy recorded in the Aberdeen Maternal and Neonatal Databank (AMND) were each matched by age, parity and year of delivery of their first baby with five women with no history of AN. Maternal and foetal outcomes were compared between these two groups of women. Comparisons were also made between the mothers with a history of AN and all other women in the AMND.

Results

A total of 134 women with a history of AN delivered 230 babies and the 670 matched women delivered 1144 babies. Mothers with AN delivered lighter babies but this difference did not persist after adjusting for maternal body mass index (BMI) in early pregnancy. Standardized birthweight (SBW) scores suggested that the AN mothers were more likely to produce babies with intrauterine growth restriction (IUGR) [relative risk (RR) 1.54, 95% confidence interval (CI) 1.11–2.13]. AN mothers were more likely to experience antepartum haemorrhage (RR 1.70, 95% CI 1.09–2.65).

Conclusions

Mothers with a history of AN are at increased risk of adverse pregnancy outcomes. The magnitude of these risks is relatively small and should be appraised holistically by psychiatric and obstetric services.

Keywords

Anorexia nervosabirth weightpregnancypregnancy complicationspregnancy outcomes
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 12 , December 2012 , pp. 2651 - 2660
Copyright
Copyright © Cambridge University Press 2012

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