Eating disorder that was diagnosed before pregnancy and pregnancy outcome

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Abstract

Objective

The purpose of this study was to determine the association of an eating disorder that was diagnosed before pregnancy and a preterm delivery and/or the delivery of a low-birth-weight or small-for-gestational-age infant.

Study design

This was a register-based follow-up study. We included 302 women who were hospitalized with an eating disorder before pregnancy who were delivered of 504 children and 900 control subjects who were delivered of 1552 children. The association of eating disorders, birth weight, and gestational age was assessed by bivariate and multivariate analyses.

Results

The risk of a low-birth-weight infant was twice as high in women with a previous eating disorder compared with women with no such disorder (odds ratio, 2.2; 95% CI, 1.4-3.2). The risk of preterm delivery and a small-for-gestational-age infant was increased to 70% and 80% (odds ratio, 1.7 [95% CI, 1.1-2.6]; odds ratio, 1.8 [95% CI, 1.3-2.4]), respectively.

Conclusion

Women who were hospitalized for an eating disorder that was diagnosed before pregnancy were at increased risk of impaired pregnancy outcome.

Section snippets

Population and methods

The study was a historic prospective follow-up study. Data were obtained from the Danish Database for Psychiatric Epidemiological Research,14 which links two national health registers: the Danish Medical Birth Register and the Danish Psychiatric Central Register, which covers the whole Danish population.

The Danish Psychiatric Central Register includes nationwide information that has been given by psychiatrists concerning all admissions to psychiatric departments since 1969.14 The Danish Medical

Results

The mean birth weight from 1973 to 1993 was 137 g lower (95% CI, 77-198 g) in children of women who were hospitalized with an eating disorder before pregnancy than in children of women without the disorder. From 1978 to 1993, the difference in mean birth weight was 134 g (70-199 g). Adjusted for gestational age from 1978 to 1993, this difference was 101 g (46-157 g, Table III).

The risk of low birth weight was twice as high in children of women who were hospitalized with an eating disorder

Comment

Previous studies and case reports have indicated that women with an eating disorder are at increased risk of being delivered of a low-birth-weight child,8., 9., 10., 11., 12., 13. but to our knowledge ours is the largest prospective study on this association to have an unexposed comparison group. The study's strength is its size, the prospective design, and the possibility to adjust for a number of potential confounders.

In a study of 50 women who had been diagnosed with an eating disorder

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    Supported by The Egmont Foundation, the Hede Nielsen Foundation, the Ivan Nielsen Foundation, and the Torben and Alice Frimodts Foundation.

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