Abstract
INTRODUCTION: Bulimia nervosa may be associated with inadequate pregnancy weight gain, nutritional deficiencies, and maternal stress. However, knowledge of maternal and newborn risks associated with bulimia nervosa during pregnancy remains limited. The objective of this study was to evaluate pregnancy outcomes among women with bulimia nervosa using a population database. METHODS: A retrospective cohort study was conducted using data from the Healthcare Cost and Utilization Project–Nationwide Inpatient Sample from 2004 to 2014. ICD-9 code 307.51 was used to identify deliveries among women with bulimia nervosa. Multivariate logistic regression analyses were performed, adjusting for confounding effects. RESULTS: Of the 9,096,788 pregnancies included in the cohort, 260 were among women with bulimia nervosa (2.86/100,000 pregnancies). Infants born to women with bulimia nervosa were more likely to be small for gestational age (SGA) compared to infants born to women without bulimia nervosa (aOR, 3.35; 95% CI, 1.85–6.09). There were no statistically significant differences in the risk of gestational hypertension, preeclampsia, gestational diabetes, or preterm delivery between groups. CONCLUSION: Contrary to previous smaller studies, we found an increased risk of SGA among pregnant women with bulimia nervosa. Therefore, we recommend increased surveillance for fetal growth restriction among women with eating disorders in pregnancy.