• Anorexia nervosa;
  • instrumental delivery;
  • perinatal complication;
  • pregnancy complication.

Objective  To examine birth outcomes and pregnancy complications in women with a history of anorexia nervosa.

Design  Prospective cohort study.

Setting  Nationwide study in Sweden.

Population  All primiparous women—discharged from hospital with a diagnosis of anorexia nervosa during 1973 to 1996—who gave birth during 1983 to 2002 (n= 1000) were compared with all non-anorexia nervosa primiparous women who gave birth during the same years (n= 827 582).

Method  Register study with data from Medical Birth Registry and National Patient Discharge Register.

Main outcome measures  Pre-eclampsia, instrumental delivery, prematurity, small for gestational age, birthweight, Apgar score and perinatal mortality.

Results  Main birth outcome measures in women with a history of anorexia nervosa were very similar to the main population. The only observed differences were a slightly lower mean birthweight and lower adjusted odds ratios for instrumental delivery in the anorexia nervosa group compared with the main population. Neither severity of the disease nor a shorter recovery phase after first hospitalisation was related to pregnancy complications or birth outcomes.

Conclusion  A history of anorexia nervosa was not associated with negative birth outcomes. Thus, special obstetric monitoring of pregnant women with history of anorexia nervosa does not seem to be warranted in a country with a satisfactory maternity surveillance.