Pregnancy complications and neonatal outcomes in women with eating disorders.
OBJECTIVE
This study reported pregnancy complications and neonatal outcomes for 49 live births in a group of women with eating disorders who were prospectively followed.


METHODS
Subjects were recruited from 246 women participating in a longitudinal study of anorexia nervosa and bulimia nervosa, now in its 12th year. Subjects were interviewed by trained assistants and completed a brief self-report instrument that assessed both birth statistics and birth-related complications. Medical records and/or self-report data describing the neonates' birth status were obtained.


RESULTS
The majority of the women with eating disorders had normal pregnancies, resulting in healthy babies. Across the group, the mean length of pregnancy was 38.7 weeks, the mean birth weight was 7.6 lb, and mean Apgar scores at 1 and 5 minutes after birth were 8.2 and 9.0, respectively. Most outcomes were positive; however, three babies (6.1%) had birth defects, and 17 (34.7%) of the women experienced postpartum depression. The mean number of obstetric complications in the group was 1.3, and 13 (26.5%) of the women delivered by cesarean section. Women who showed symptoms of either anorexia nervosa or bulimia nervosa during pregnancy had a higher frequency of birth by cesarean section and postpartum depression than did nonsymptomatic women.


CONCLUSIONS
Pregnant women with active eating disorders appear to be at greater risk for delivery by cesarean section and for postpartum depression. Pregnant women with past or current eating disorders should be viewed as being at high risk and monitored closely both during and after pregnancy to optimize maternal and fetal outcomes.
Franko
D L
DL
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA.
Blais
M A
MA
Becker
A E
AE
Delinsky
S S
SS
Greenwood
D N
DN
Flores
A T
AT
Ekeblad
E R
ER
Eddy
K T
KT
Herzog
D B
DB
D000328:Adult; D000856:Anorexia Nervosa / Q000175:diagnosis / Q000453:epidemiology; D001034:Apgar Score; D001724:Birth Weight; D002032:Bulimia / Q000175:diagnosis / Q000453:epidemiology; D002585:Cesarean Section / Q000706:statistics & numerical data; D015897:Comorbidity; D000013:Congenital Abnormalities / Q000175:diagnosis / Q000453:epidemiology; D019052:Depression, Postpartum / Q000175:diagnosis / Q000453:epidemiology; D001068:Feeding and Eating Disorders / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007744:Obstetric Labor Complications / Q000175:diagnosis / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012307:Risk Factors; D012720:Severity of Illness Index