Eating disorders result in negative feelings towards pregnancy
MedWire News: Pregnant women who have ever experienced an eating disorder are more likely than women in the general population to have a negative attitude towards their pregnancy, show study results.
These women are also more likely to have needed to see a fertility specialist for fertility problems, and were more likely to describe their pregnancy as unplanned, compared with their healthy counterparts.
"This research highlights that there are risks to fertility associated with eating disorders," said lead author Abigail Easter, from Kings College London, UK.
"However, the high rates of unplanned pregnancies in women with a history of anorexia suggest that women may be underestimating their chances of conceiving," she added.
Easter and team believe their findings should encourage healthcare professionals and clinicians to inform women with eating disorders that they can still be fertile.
The team used data for 11,088 pregnant women who participated in the UK Avon Longitudinal Study of Parents and Children between 1991 and 1992 to investigate fertility in women with a lifetime eating disorder. The women completed questionnaires at 12 and 18 weeks gestation.
In all, 1.5% of women reported ever having anorexia nervosa, 1.8% answered that they had lifetime bulimia nervosa, and an additional 0.7% reported having ever had both conditions. The remaining women formed the comparison group.
After adjusting for factors including age and education level, women with anorexia and those with anorexia and bulimia were 1.6 and 1.9 times more likely to have been seen by a doctor for lifetime fertility problems compared with women in the general population.
Furthermore, women with both eating disorders were more than twice as likely as women in the general population to have received treatment to help them conceive, at 6.2% versus 2.7%.
The researchers observed that women with lifetime anorexia were 50% less likely than women in the general population to report that their pregnancy was intentional, and also reported higher levels of unplanned pregnancies, at 41.5% versus 28.3%.
Overall, write Easter et al in BJOG: An International Journal of Obstetrics and Gynaecology, women with eating disorders were no more likely to take longer than 12 months to conceive than were women without these conditions, although they did see some evidence that women with both anorexia and bulimia took longer than 6 months.
Finally, women with eating disorders were more likely to report negative feelings toward their pregnancy; the odd ratio of having negative feelings at 18 weeks gestation among women with anorexia and bulimia were 2.3 times that for the general population.
The research team concludes that the early part of pregnancy may be the hardest for women with a history of eating disorders and "additional support should be given in this period."
Easter added: "Women planning a pregnancy should ideally seek treatment for their eating disorder symptoms prior to conception and health professionals should be aware of eating disorders when assessing fertility and providing treatment for this."
MedWire (www.medwire-news.md) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011
By Sarah Guy