Objective
The purpose of this study was to assess pregnancy, obstetric, and perinatal health
outcomes and complications in women with lifetime eating disorders.
Study Design
Female patients (n = 2257) who were treated at the Eating Disorder Clinic of Helsinki
University Central Hospital from 1995-2010 were compared with unexposed women from
the population (n = 9028). Register-based information on pregnancy, obstetric, and
perinatal health outcomes and complications were acquired for all singleton births
during the follow-up period among women with broad anorexia nervosa (AN; n = 302 births),
broad bulimia nervosa (BN; n = 724), binge eating disorder (BED; n = 52), and unexposed
women (n = 6319).
Results
Women with AN and BN gave birth to babies with lower birthweight compared with unexposed
women, but the opposite was observed in women with BED. Maternal AN was related to
anemia, slow fetal growth, premature contractions, short duration of the first stage
of labor, very premature birth, small for gestational age, low birthweight, and perinatal
death. Increased odds of premature contractions, resuscitation of the neonate, and
very low Apgar score at 1 minute were observed in mothers with BN. BED was associated
positively with maternal hypertension, long duration of the first and second stage
of labor, and birth of large-for-gestational-age infants.
Conclusion
Eating disorders appear to be associated with several adverse perinatal outcomes,
particularly in offspring. We recommend close monitoring of pregnant women with either
a past or current eating disorder. Attention should be paid to children who are born
to these mothers.
Key words
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Article Info
Publication History
Published online: April 07, 2014
Accepted:
March 31,
2014
Received in revised form:
February 18,
2014
Received:
December 10,
2013
Footnotes
Supported by doctoral programs in Public Health, Academy of Finland, and by research grants from Helsinki University Central Hospital.
The funders were not involved in the conduct of the study, collection, management, or analysis and interpretation of the data.
J.T.S. and J.M.S. have been involved in a research collaboration with Janssen-Cilag. J.T.S. has received fees for giving expert opinions to Lightlake Sinclair and attended one international conference supported by Janssen-Cilag. J.M.S. has received a lecturing fee from AstraZeneca. J.H. has been in research collaboration with Janssen-Cilag and Eli Lilly and has been a member of the expert advisory group for Astellas. The other authors report no conflict of interest.
Cite this article as: Linna MS, Raevuori A, Haukka J, et al. Pregnancy, obstetric, and perinatal health outcomes in eating disorders. Am J Obstet Gynecol 2014;211:392.e1-8.
Identification
Copyright
© 2014 Published by Elsevier Inc.
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- Statistical significance of eating disorders and adverse perinatal outcomesAmerican Journal of Obstetrics & GynecologyVol. 213Issue 1
- PreviewThe study by Linna et al1 posited that “eating disorders appear to be associated with several adverse perinatal outcomes, particularly in offspring.” The adverse outcomes included anemia, slow fetal growth, premature contractions, and perinatal death. However, this conclusion cannot be supported by the data because the authors failed to correct the standard value of P = .05 to account for the large number of hypothesis tests. This leads to what is known as type 2 error and causes a hypothesis to be accepted that is actually false.
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