Pregnancy, obstetric, and perinatal health outcomes in eating disorders.
OBJECTIVE
The purpose of this study was to assess pregnancy, obstetric, and perinatal health outcomes and complications in women with lifetime eating disorders.


METHODS
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.


CONCLUSIONS
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.
Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland. Electronic address: milla.linna@helsinki.fi.
Milla S
MS
Linna
Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland; Department of Adolescent Psychiatry, Helsinki University Central Hospital, Helsinki, Finland; Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland; Institute of Clinical Medicine, Child Psychiatry, University of Turku, Turku, Finland.
Anu
A
Raevuori
Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland; Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland.
Jari
J
Haukka
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland; Department of Social Psychiatry, Tampere School of Public Health, Tampere, Finland.
Jaana M
JM
Suvisaari
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland; Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland.
Jaana T
JT
Suokas
National Institute for Health and Welfare, Helsinki, Finland; Nordic School of Public Health, Gothenburg, Sweden.
Mika
M
Gissler
D000328:Adult; D000856:Anorexia Nervosa; D001034:Apgar Score; D052018:Bulimia Nervosa; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D016014:Linear Models; D016015:Logistic Models; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology*; D011256:Pregnancy Outcome; D012042:Registries
eating disorder; obstetric complication; perinatal health; pregnancy; reproductive health