Variation in reproductive outcomes of women with histories of bulimia nervosa, anorexia nervosa, or eating disorder not otherwise specified relative to the general population and closest-aged sisters

Jennifer Tabler; Rebecca L. Utz; Ken R. Smith; Heidi A. Hanson; Claudia Geist

doi:10.1002/eat.22827

Variation in reproductive outcomes of women with histories of bulimia nervosa, anorexia nervosa, or eating disorder not otherwise specified relative to the general population and closest-aged sisters

Jennifer Tabler
, Rebecca L. Utz
, Ken R. Smith
, Heidi A. Hanson
, Claudia Geist

Research output: Contribution to journal › Article › peer-review

32 Scopus citations

Abstract

Objective: This study seeks to examine the long-term reproductive consequences of eating disorders (ED), to assess variation in reproductive outcomes by ED type, and to examine reproductive differences between women with previous ED diagnosis and their discordant sisters. Method: Using a sample of women with previous ED diagnosis generated by the Utah Population Database, this study compares the fecundity (parity) and age at first birth of women by ED subtype (bulimia nervosa [BN], anorexia nervosa [AN], and ED not otherwise specified [EDNOS]) (n = 1,579). We also employed general population match case–control, and discordant sibling pair analyses, to estimate the magnitude of association between EDs and reproductive outcomes. Results: Women previously diagnosed with AN or EDNOS experienced delayed first birth (HRR = 0.33, HRR = 0.34, respectively) and lower parity (IRR = 0.19, IRR = 0.22, respectively) relative to BN (p <.05), the general population (p <.05), and closest-aged sisters (p <.05). Women previously diagnosed with BN experienced more moderate reductions and delays to their reproduction, and had similar reproductive outcomes as their discordant sisters. Discussion: Clinicians should consider ED type and family fertility histories when addressing the long-term reproductive health needs of women with prior AN, BN, or EDNOS diagnosis. Women previously diagnosed with AN or EDNOS likely experience the greatest reductions and delays in reproduction across their lifespan. Reproductive health screenings may be especially critical for the wellbeing of women with a history of AN or EDNOS.

Original language	English
Pages (from-to)	102-111
Number of pages	10
Journal	International Journal of Eating Disorders
Volume	51
Issue number	2
DOIs	https://doi.org/10.1002/eat.22827
State	Published - Feb 2018
Externally published	Yes

Funding

National Science Foundation-Doctoral Dissertation Research Improvement Grant, Grant Number: NSF-DDRIG 11-547; the Consortium for Family and Health Research Internal Pilot Grant (C-FAHR), University of Utah Direct funding from the National Science Foundation-Doctoral Dissertation Research Improvement Grant (NSF-DDRIG 11-547) (Co-PI: Rebecca Utz; Co-PI: Jennifer Tabler) and the Consortium for Family and Health Research Internal Pilot Grant (C-FAHR), University of Utah (PI: Jennifer Tabler) supported this research. Heidi A. Hanson is partially funded by a National Institutes of Health K12 Award, 1K12HD085852-01. We thank the Pedigree and Population Resource of the Huntsman Cancer Institute, University of Utah (funded in part by the Huntsman Cancer Foundation) for its role in the ongoing collection, maintenance and support of the Utah Population Database (UPDB). We also acknowledge partial support for the UPDB through grant P30 CA2014 from the National Cancer Institute, University of Utah and from the University of Utah's Program in Personalized Health and Center for Clinical and Translational Science. We thank the University of Utah Center for Clinical and Translational Science (CCTS) (funded by NIH Clinical and Translational Science Awards), the Pedigree and Population Resource, University of Utah Information Technology Services and Biomedical Informatics Core for establishing the Master Subject Index between the Utah Population Database, the University of Utah Health Sciences Center and Intermountain Health Care. Finally, research was supported by the NCRR grant, “Sharing Statewide Health Data for Genetic Research” (R01 RR021746, G. Mineau, PI) with additional support from the Utah State Department of Health and the University of Utah.

Keywords

EDNOS
anorexia
bulimia
eating disorders
fertility
reproduction
sibling pairs

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10.1002/eat.22827

Cite this

@article{65a0dd3c2f474e1d83eefe1c761d1a8a,

title = "Variation in reproductive outcomes of women with histories of bulimia nervosa, anorexia nervosa, or eating disorder not otherwise specified relative to the general population and closest-aged sisters",

abstract = "Objective: This study seeks to examine the long-term reproductive consequences of eating disorders (ED), to assess variation in reproductive outcomes by ED type, and to examine reproductive differences between women with previous ED diagnosis and their discordant sisters. Method: Using a sample of women with previous ED diagnosis generated by the Utah Population Database, this study compares the fecundity (parity) and age at first birth of women by ED subtype (bulimia nervosa [BN], anorexia nervosa [AN], and ED not otherwise specified [EDNOS]) (n = 1,579). We also employed general population match case–control, and discordant sibling pair analyses, to estimate the magnitude of association between EDs and reproductive outcomes. Results: Women previously diagnosed with AN or EDNOS experienced delayed first birth (HRR = 0.33, HRR = 0.34, respectively) and lower parity (IRR = 0.19, IRR = 0.22, respectively) relative to BN (p <.05), the general population (p <.05), and closest-aged sisters (p <.05). Women previously diagnosed with BN experienced more moderate reductions and delays to their reproduction, and had similar reproductive outcomes as their discordant sisters. Discussion: Clinicians should consider ED type and family fertility histories when addressing the long-term reproductive health needs of women with prior AN, BN, or EDNOS diagnosis. Women previously diagnosed with AN or EDNOS likely experience the greatest reductions and delays in reproduction across their lifespan. Reproductive health screenings may be especially critical for the wellbeing of women with a history of AN or EDNOS.",

keywords = "EDNOS, anorexia, bulimia, eating disorders, fertility, reproduction, sibling pairs",

author = "Jennifer Tabler and Utz, \{Rebecca L.\} and Smith, \{Ken R.\} and Hanson, \{Heidi A.\} and Claudia Geist",

note = "Publisher Copyright: {\textcopyright} 2018 Wiley Periodicals, Inc.",

year = "2018",

month = feb,

doi = "10.1002/eat.22827",

language = "English",

volume = "51",

pages = "102--111",

journal = "International Journal of Eating Disorders",

issn = "0276-3478",

number = "2",

}

Variation in reproductive outcomes of women with histories of bulimia nervosa, anorexia nervosa, or eating disorder not otherwise specified relative to the general population and closest-aged sisters. / Tabler, Jennifer; Utz, Rebecca L.; Smith, Ken R. et al.
In: International Journal of Eating Disorders, Vol. 51, No. 2, 02.2018, p. 102-111.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Variation in reproductive outcomes of women with histories of bulimia nervosa, anorexia nervosa, or eating disorder not otherwise specified relative to the general population and closest-aged sisters

AU - Tabler, Jennifer

AU - Utz, Rebecca L.

AU - Smith, Ken R.

AU - Hanson, Heidi A.

AU - Geist, Claudia

PY - 2018/2

Y1 - 2018/2

N2 - Objective: This study seeks to examine the long-term reproductive consequences of eating disorders (ED), to assess variation in reproductive outcomes by ED type, and to examine reproductive differences between women with previous ED diagnosis and their discordant sisters. Method: Using a sample of women with previous ED diagnosis generated by the Utah Population Database, this study compares the fecundity (parity) and age at first birth of women by ED subtype (bulimia nervosa [BN], anorexia nervosa [AN], and ED not otherwise specified [EDNOS]) (n = 1,579). We also employed general population match case–control, and discordant sibling pair analyses, to estimate the magnitude of association between EDs and reproductive outcomes. Results: Women previously diagnosed with AN or EDNOS experienced delayed first birth (HRR = 0.33, HRR = 0.34, respectively) and lower parity (IRR = 0.19, IRR = 0.22, respectively) relative to BN (p <.05), the general population (p <.05), and closest-aged sisters (p <.05). Women previously diagnosed with BN experienced more moderate reductions and delays to their reproduction, and had similar reproductive outcomes as their discordant sisters. Discussion: Clinicians should consider ED type and family fertility histories when addressing the long-term reproductive health needs of women with prior AN, BN, or EDNOS diagnosis. Women previously diagnosed with AN or EDNOS likely experience the greatest reductions and delays in reproduction across their lifespan. Reproductive health screenings may be especially critical for the wellbeing of women with a history of AN or EDNOS.

AB - Objective: This study seeks to examine the long-term reproductive consequences of eating disorders (ED), to assess variation in reproductive outcomes by ED type, and to examine reproductive differences between women with previous ED diagnosis and their discordant sisters. Method: Using a sample of women with previous ED diagnosis generated by the Utah Population Database, this study compares the fecundity (parity) and age at first birth of women by ED subtype (bulimia nervosa [BN], anorexia nervosa [AN], and ED not otherwise specified [EDNOS]) (n = 1,579). We also employed general population match case–control, and discordant sibling pair analyses, to estimate the magnitude of association between EDs and reproductive outcomes. Results: Women previously diagnosed with AN or EDNOS experienced delayed first birth (HRR = 0.33, HRR = 0.34, respectively) and lower parity (IRR = 0.19, IRR = 0.22, respectively) relative to BN (p <.05), the general population (p <.05), and closest-aged sisters (p <.05). Women previously diagnosed with BN experienced more moderate reductions and delays to their reproduction, and had similar reproductive outcomes as their discordant sisters. Discussion: Clinicians should consider ED type and family fertility histories when addressing the long-term reproductive health needs of women with prior AN, BN, or EDNOS diagnosis. Women previously diagnosed with AN or EDNOS likely experience the greatest reductions and delays in reproduction across their lifespan. Reproductive health screenings may be especially critical for the wellbeing of women with a history of AN or EDNOS.

KW - EDNOS

KW - anorexia

KW - bulimia

KW - eating disorders

KW - fertility

KW - reproduction

KW - sibling pairs

UR - https://www.scopus.com/pages/publications/85041577923

U2 - 10.1002/eat.22827

DO - 10.1002/eat.22827

M3 - Article

C2 - 29331083

AN - SCOPUS:85041577923

SN - 0276-3478

VL - 51

SP - 102

EP - 111

JO - International Journal of Eating Disorders

JF - International Journal of Eating Disorders

IS - 2

ER -

Variation in reproductive outcomes of women with histories of bulimia nervosa, anorexia nervosa, or eating disorder not otherwise specified relative to the general population and closest-aged sisters

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