Fertility and reproduction in women with anorexia nervosa: A controlled study

Background: Women who have anorexia nervosa may experience difficulties wit h fertility and reproduction. Method: We examined fertility and reproductive history in 66 women who had a history of anorexia nervosa (DSM-III-R) and 98 randomly selected communit y controls as part of a follow-up investigation examining the course of ano rexia nervosa. Results: Although women with a history of anorexia nervosa and controls did not differ on rate of pregnancy, mean number of pregnancies per woman, or age at first pregnancy, women with anorexia nervosa had significantly more miscarriages and cesarean deliveries, and the offspring of women with anore xia nervosa were significantly more likely to be born prematurely and were of lower birth weight than offspring of controls. There were no differences between women with active versus remitted anorexia nervosa on any of these measures; however, offspring of anorexic women with no history of bulimia nervosa had significantly lower body weight than offspring of anorexic wome n with a lifetime history of bulimia nervosa. Conclusion: Our results argue for intensive pre natal care for women with b oth active and remitted anorexia nervosa to ensure adequate prenatal nutrit ion and fetal development.