title: Reproductive health outcomes in eating disorders.
abstract: OBJECTIVE
  Eating disorders are common psychiatric disorders in women at childbearing age. Previous research suggests that eating disorders are associated with fertility problems, unplanned pregnancies, and increased risk of induced abortions and miscarriages. The purpose of this study was to assess how eating disorders are related to reproductive health outcomes in a representative patient population.
  
  
  METHODS
  Female patients (N = 2,257) treated at the eating disorder clinic of Helsinki University Central Hospital during 1995-2010 were compared with matched controls identified from the Central Population Register (N = 9,028). Patients had been diagnosed (ICD-10) with anorexia nervosa (AN), atypical AN, bulimia nervosa (BN), atypical BN, or binge eating disorder (BED, according to DSM-IV research criteria). Register-based data on number of children, pregnancies, childbirths, induced abortions, miscarriages, and infertility treatments were used to measure reproductive health outcomes.
  
  
  RESULTS
  Patients were more likely to be childless than controls [odds ratio (OR) 1.86; 95% confidence interval (CI) 1.62-2.13, p < .001]. Pregnancy and childbirth rates were lower among patients than among controls. BN was associated with increased risk of induced abortion compared to controls (OR 1.85; 95% CI 1.43-2.38, p < .001), whereas BED was associated with elevated risk of miscarriage (OR 3.18; 95% CI 1.52-6.66, p = .002).
  
  
  CONCLUSIONS
  Reproductive health outcomes are compromised in women with a history of eating disorders across all eating disorder types. Our findings emphasize the importance of reproductive health counseling and monitoring among women with eating disorders.
authors.affiliation: Hjelt Institute, Department of Public Health, University of Helsinki, Finland.
authors.forename: Milla S
authors.initials: MS
authors.lastname: Linna
authors.forename: Anu
authors.initials: A
authors.lastname: Raevuori
authors.forename: Jari
authors.initials: J
authors.lastname: Haukka
authors.forename: Jaana M
authors.initials: JM
authors.lastname: Suvisaari
authors.forename: Jaana T
authors.initials: JT
authors.lastname: Suokas
authors.forename: Mika
authors.initials: M
authors.lastname: Gissler
mesh_terms: D000028:Abortion, Induced / Q000706:statistics & numerical data; D000022:Abortion, Spontaneous / Q000453:epidemiology*; D000328:Adult; D015992:Body Mass Index; D016022:Case-Control Studies; D002648:Child; D001068:Feeding and Eating Disorders / Q000145:classification / Q000150:complications* / Q000523:psychology; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D007247:Infertility, Female / Q000453:epidemiology* / Q000628:therapy; D017533:Marital Status; D010298:Parity; D011247:Pregnancy; D012042:Registries; D060728:Reproductive Health; D017584:Reproductive History
keywords: eating disorders; fertility; induced abortion; miscarriage; pregnancy; reproductive health