Eating Disorders May Jeopardize Pregnancy Outcomes

The results of a Swedish study confirm that fetal outcome may be compromised in women with a past or active eating disorder. "These women should therefore be recognized as high-risk patients during pregnancy," Dr. Angelica Linden Hirschberg from Karolinska University Hospital in Stockholm told Reuters Health.

She and her colleagues followed 49 pregnant women who had an eating disorder or a history of one. None of the women had previously given birth and none of the women were smokers.

Twenty-four women had anorexia nervosa, 20 had bulimia nervosa, and 5 had an unspecified eating disorders. The investigators compared their pregnancy course and fetal outcome with that of a healthy group of 68 pregnant women.

An increased risk of severe vomiting was found among the women with past or current eating disorders. These women also had a greater risk of delivering an infant with a lower birth weight and smaller head circumference compared with the healthy women, the research team reports in the journal Obstetrics and Gynecology. Similar findings have been noted in previous studies.

Women with eating disorders also had an increased risk of giving birth to a small for gestational age infant, Hirschberg told Reuters Health.

The diminished average head size in children born to mothers with a history of an eating disorder is a new finding, she and colleagues point out in their report.

While the precise mechanisms behind these negative fetal outcomes are not known, "it is likely that inadequate eating behavior during pregnancy might result in a deficient nutrient supply to the fetus," they suggest. This is supported by the tendency toward an increased rate of intrauterine growth restriction among women with eating disorders in this study.

"The long-term effects of our findings, and particularly of decreased head circumference, seem to be very important to address in future studies," Hirschberg said.

SOURCE: Obstetrics and Gynecology, January 2005.

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