Mental Health

Long-Term Effects of Eating Disorders on Fertility and Pregnancy

Long-Term Effects of Eating Disorders on Fertility and Pregnancy

Fertility was modestly affected by lifetime eating disorders.

Eating disorders commonly disrupt menstrual cycles, but information is sparse about long-term effects of these disorders on fertility and attitudes toward pregnancy. Investigators examined these issues in a cohort of 14,600 women that included 171 with lifetime anorexia nervosa, 199 with lifetime bulimia nervosa, and 82 with lifetime anorexia+bulimia.

Long-Term Effects of Eating Disorders on Fertility and Pregnancy

Fertility was modestly affected by lifetime eating disorders.

Eating disorders commonly disrupt menstrual cycles, but information is sparse about long-term effects of these disorders on fertility and attitudes toward pregnancy. Investigators examined these issues in a cohort of 14,600 women that included 171 with lifetime anorexia nervosa, 199 with lifetime bulimia nervosa, and 82 with lifetime anorexia+bulimia.

Twenty-one percent of women with anorexia and 20% of those with anorexia+bulimia — but only 12% of those in the general population — had been seen by a physician for lifetime fertility problems. Compared with women in the general population, those with eating disorders were equally likely to require >12 months to conceive; however, women with anorexia+bulimia were more likely than those in the general population (6.2% vs. 2.7%) to have received medical assistance in conceiving their current pregnancies and were more likely to take >6 months to conceive. Rates of intentional pregnancy were 58% in women with anorexia and 72% in the general population. Women with eating disorders were more likely to have negative reactions when they first discovered they were pregnant, although these feelings tended to abate by 18 weeks’ gestation. Women with lifetime anorexia or anorexia+bulimia were more likely than those in the general population to view motherhood as a personal sacrifice.

Comment: These data show that fertility is only modestly affected in women with lifetime eating disorders. Thus, healthcare providers should counsel women with histories of eating disorders that they probably can have children, even when menstrual patterns are disturbed. Contraceptive counseling should be provided as appropriate. Because of their attitudes toward pregnancy, these women might require additional psychological support, especially during early pregnancy.
— Robert W. Rebar, MD

Published in Journal Watch Women’s Health September 8, 2011
CITATION(S):
Easter A et al. Fertility and prenatal attitudes towards pregnancy in women with eating disorders: Results from the Avon Longitudinal Study of Parents and Children. BJOG 2011 Aug 3; [e-pub ahead of print]. (http://dx.doi.org/10.1111/j.1471-0528.2011.03077.x)

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