from medicontext.co.il
WESTPORT, CT (Reuters Health) – Pregnant women with active eating disorders are at increased risk of postpartum depression and delivery by cesarean section, according to a report in the September issue of the American Journal of Psychiatry.
Dr. David B. Herzog, of Massachusetts General Hospital, Boston, and colleagues prospectively followed the course of pregnancy in a cohort women with anorexia or bulimia.
Subjects were interviewed and completed a self-report survey that evaluated birth-related complications and statistics. In addition, the researchers reviewed medical records or self-report data describing the status of 49 live infants.
"The majority of the women with eating disorders had normal pregnancies, resulting in healthy babies," the investigators explain. The mean length of pregnancy across the group was 38.7 weeks and the mean birth weight was 7.6 lbs. The mean Apgar score 1 minute after birth was 8.2 and the mean score 5 minutes after birth was 9.0.
The team notes that while most outcomes were positive, three infants had birth defects and 17 women developed postpartum depression. The mean number of pregnancy problems or birth complications was 1.3, according to the report.
Women with symptoms of anorexia or bulimia had a significantly higher number of cesarean sections than asymptomatic women (p = 0.04). More symptomatic women also had a higher frequency of postpartum depression (10 subjects) than asymptomatic women (7 women).
"Pregnant women with past or current eating disorders should be viewed as being at high risk and monitored closely both during and after pregnancy to optimize maternal and fetal outcomes," Dr. Herzog and colleagues conclude.
Am J Psychiatry 2001;158:1461-1466.
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