Maternal and neonatal outcomes among pregnant women with eating disorders

Eating disorders (ED), most prevalent among women of reproductive age, may negatively impact both maternal and fetal health during pregnancy. However, their effects remain inadequately explored. This study aimed to evaluate the associations between maternal ED and perinatal outcomes.

A retrospective population-based cohort study of all delivery admissions from 2016 to 2021 was conducted using the United States' Healthcare Cost and Utilization Project-National Inpatient Sample. Pregnancies complicated by maternal ED were identified using ICD-10 codes F50.x. Associations between antenatal ED and adverse maternal and neonatal outcomes were assessed using multivariable logistic regression. Potential confounders adjusted for include baseline maternal demographics and relevant clinical factors.

Among 4,337,612 delivery admissions, 1,262 involved an ED diagnosis, with prevalence increasing from 23.9 to 37.6/100,000 (p<0.0001) over the study period. Patients with an ED were more likely to use tobacco, cannabis, and alcohol. Anxiety disorders, bipolar affective disorder, and depression were also more common among the ED group. Maternal ED was associated with higher risks of anemia (aOR 2.8, 95 % CI 2.6-3.3), preterm labor (1.4, 1.1-1.7), disseminated intravascular coagulation (6.2, 1.5-24.7), postpartum hemorrhage (1.9, 1.6-2.4), uterine rupture (4.4, 1.6-11.6), genitourinary tract infection (1.9, 1.1-3.3), and prolonged hospitalization (2.3, 1.7-3.1). Neonates of affected mothers were more likely to present with congenital anomalies (2.3, 1.6-3.4), IUGR (1.7, 1.4-2.1), fetal distress (1.3, 1.1-1.5), and preterm birth (1.4, 1.2-1.7).

Pregnant individuals with ED constitute a high-risk group with elevated susceptibility to maternal and neonatal complications. Early recognition and integrated multidisciplinary care are crucial to improve outcomes.