Eating Disorders Increases Incidence of Complications in Pregnancy

OBGYN Reston VA

OBGYN Reston, VAEating disorders are a common yet under-recognized condition in women. While many are able to overcome the disorder to lead a normal life, it appears that in the long term eating disorders may have an impact on pregnancy. But what exactly is the relationship between the two? In this article, we briefly review the connection between eating disorders and complications in pregnancy.

Eating disorders
There are a number of different kinds of eating disorders, but the most commonly identified one is anorexia nervosa. Studies have estimated that around 1 to 2 out of every 100 women in the United States has anorexia nervosa. As a potentially life threatening condition, anorexia nervosa requires specific treatment measures to be taken in order to prevent serious health problems and death.

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The specific health problems associated with eating disorders are many. The lack of sufficient quantities of essential nutrients such as carbohydrates, vitamins, proteins and fats can alter normal physiological processes in the body, resulting in changes in metabolism and hormone production. In some way or another, these changes were believed to impact normal pregnancy, increasing complication rates dramatically.

The link between pregnancy complications and eating disorders
Given the above physiological changes that can take place, a study group in Finland proceeded to assess what the link is between eating disorders and complications in pregnancy.

The study conducted by Linna et al this year assessed the health of 2257 women who were treated for eating disorders between 1995 and 2010 at the Eating Disorder Clinic at Helsinki University Central Hospital. The data was extracted from a register that detailed patients who underwent treatment for eating disorders and who subsequently became pregnant. In the 15 years that they looked at, women who had anorexia nervosa gave birth to 302 babies while w3omen with bulimia were delivered of 724 babies. The data obtained was compared to that of 3642 women from Finland who had been delivered of 6319 babies.

The complication rates noted were rather significant. Women with anorexia and bulimia gave birth to babies who had a low birth weight when compared to controls. In addition, the growth of the fetus was a lot slower in mothers with anorexia nervosa. Women with eating disorders had anemia, and following pregnancy noted premature births, low birth weight and a higher incidence of prenatal death.

In women with bulimia, the babies born tended to require some form of cardiovascular resuscitation, or scored poorly on parameters that assessed the health of the baby after birth (called the Apgar score).

Another eating disorder called binge eating disorders produced slightly different results. Babies tended to be of normal birth weight. However, binge eating disorder was associated with a greater chance of the mother developing high blood pressure in pregnancy along with a longer duration of labour). Furthermore, the babies born were larger than normal for their gestational age.

There is of course a reason for why these complications can occur. Firstly, the mother herself is extremely underweight, and the nutrition that the fetus receives is a limited amount of the essential nutrients that it needs to thrive. Secondly, the alteration in the hormone levels in the mother and the change in their blood pressure has an impact on the growth and development of the fetus, resulting in either premature babies or even still born babies.

But the finding from this study is not entirely new, though there is a stark paucity of data. There is published research that has demonstrated that eating disorders are associated with altered weight gain patterns during gestation. Furthermore, pregnant women who have in the past had an eating disorder or are actively suffering from one have a high risk of delivering babies with small head circumference and low birth weight. In addition, there are clear signs of foetal distress during its growth within the mother’s womb.

Despite this evidence, there still remains a myth that women with eating disorders cannot get pregnant. This is not true in any sense, but given that women who do have eating disorders rarely admit to it, it may well be that the number of pregnant women with eating disorders is under-appreciated. Admitting that they have the disorder or have a problem with their body’s self image is the first step to a health pregnancy, but this step is the hardest for many women. A likely cause for this is the stigma that is attached to eating disorders in public, and admitting it brings a fear that the individual will be ‘labelled anorexic’ or otherwise depending on their clinical symptoms.

Seeking help
So what exactly is the best way to handle this situation? It is best to be open and honest about your health and practices with your health care practitioner, primarily as the information you offer them can help them help you, plus any discussion had are always confidential and never judged. Admitting eating disorders of any sort during pregnancy is essential to maintain the health of the growing fetus and the mother, as steps can be taken to ensure that sufficient amount of the essential nutrients can be provided to the mother.

It is strongly recommended that women with eating disorders visit their healthcare practitioner to get the help that they need during pregnancy.

Reference
1. Linna, Milla S., et al. “Pregnancy, obstetric, and perinatal health outcomes in eating disorders.” American journal of obstetrics and gynecology (2014).
2. Kouba, Saloua, et al. “Pregnancy and neonatal outcomes in women with eating disorders.” Obstetrics & Gynecology 105.2 (2005): 255-260.

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