94anorexia and bulimia nervosa during pregnancy

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AN and BN are typically manifested in the early postpubertal to young adult years [12] and continue throughout the reproductive years [13]. Amenorrhea is a diagnostic criteria for AN, suggesting that pregnancy is of little concern in a woman with this eating disorder. However, approximately 10% of women who sought treatment in an infertility clinic presented with AN or BN [14]. Moreover, 60% of women with oligomenorrhea had eating disorders [14], indicating the desire for fertility despite any dysmenorrhea associated with AN or BN.

Studies confirm that women with AN may become pregnant [15, 16], particularly those women who are undergoing active treatment or are in remission [17]. While pregnancies in women with active BN are more common than in women with active AN, women with histories of AN and BN have similar pregnancy rates compared to the general population of women of childbearing age [17, 18].

Many factors are important to a successful course and outcome of pregnancy. Yet, prepregnancy weight and weight gain by the mother during pregnancy (see Chap. 2, "Optimal Weight Gain") are the two most salient indicators of infant outcome, including birth weight [19, 20]. Common characteristics of AN and BN are body image dissatisfaction or disturbances and desire to prevent weight gain. Thus, pregnancy presents a pivotal life cycle stage for a woman with AN or BN, because body weight and shape transform gradually over the course of pregnancy and abruptly upon delivery.

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