title: Medication Use before, during, and after Pregnancy among Women with Eating Disorders: A Study from the Norwegian Mother and Child Cohort Study.
abstract: BACKGROUND
  Little is known about medication use among women with eating disorders in relation to pregnancy.
  
  
  OBJECTIVE
  To explore patterns of and associations between use of psychotropic, gastrointestinal and analgesic medications and eating disorders in the period before, during and after pregnancy.
  
  
  METHODS
  This study is based on the Norwegian Mother and Child Cohort Study (MoBa). A total of 62,019 women, enrolled at approximately 17 weeks' gestation, had valid data from the Norwegian Medical Birth Registry and completed three MoBa questionnaires. The questionnaires provided diagnostic information on broadly defined anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED) and recurrent self-induced purging in the absence of binge eating (EDNOS-P), along with self-reported use of medication six months before, during, and 0-6 months after pregnancy.
  
  
  RESULTS
  The prevalence of eating disorder subtypes before and/or during pregnancy was: 0.09% AN (n = 54), 0.94% BN (n = 585), 0.10% EDNOS-P (n = 61) and 5.00% BED (n = 3104). The highest over-time prevalence of psychotropic use was within the AN (3.7-22.2%) and EDNOS-P (3.3-9.8%) groups. Compared to controls, BN was directly associated with incident use of psychotropics in pregnancy (adjusted RR: 2.25, 99% CI: 1.17-4.32). Having AN (adjusted RR: 5.11, 99% CI: 1.53-17.01) or EDNOS-P (adjusted RR: 6.77, 99% CI: 1.41-32.53) was directly associated with use of anxiolytics/sedatives postpartum. The estimates of use of analgesics (BED) and laxatives (all eating disorders subtypes) were high at all time periods investigated.
  
  
  CONCLUSIONS
  Use of psychotropic, gastrointestinal, and analgesic medications is extensive among women with eating disorders in the period around pregnancy. Female patients with eating disorders should receive evidence-based counseling about the risk of medication exposure versus the risk of untreated psychiatric illness during pregnancy and postpartum.
authors.affiliation: PharmacoEpidemiology and Drug Safety Research Group, School of Pharmacy, PharmaTox Strategic Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway.
authors.forename: Angela
authors.initials: A
authors.lastname: Lupattelli
authors.affiliation: Department of Clinical Pharmacology, St Olav's University Hospital, Trondheim, Norway; Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Olav
authors.initials: O
authors.lastname: Spigset
authors.affiliation: Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway.
authors.forename: Leila
authors.initials: L
authors.lastname: Torgersen
authors.affiliation: UNC Center of Excellence for Eating Disorders, Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Zerwas
authors.affiliation: Clinic for Eating Disorders, Oslo, Norway.
authors.forename: Marianne
authors.initials: M
authors.lastname: Hatle
authors.affiliation: Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway; Department of Psychiatry, University of Oslo, Oslo, Norway.
authors.forename: Ted
authors.initials: T
authors.lastname: Reichborn-Kjennerud
authors.affiliation: UNC Center of Excellence for Eating Disorders, Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America; Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Bulik
authors.affiliation: PharmacoEpidemiology and Drug Safety Research Group, School of Pharmacy, PharmaTox Strategic Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway; Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway.
authors.forename: Hedvig
authors.initials: H
authors.lastname: Nordeng
mesh_terms: D000328:Adult; D000700:Analgesics / Q000008:administration & dosage*; D001068:Feeding and Eating Disorders / Q000145:classification / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D054368:Laxatives / Q000008:administration & dosage*; D009664:Norway / Q000453:epidemiology; D011181:Postnatal Care; D011247:Pregnancy; D011295:Prenatal Care; D011619:Psychotropic Drugs / Q000008:administration & dosage*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000700:Analgesics; D054368:Laxatives; D011619:Psychotropic Drugs