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Fertility and Reproduction after Recovery from Anorexia Nervosa: A Systematic Review and Meta-Analysis of Long-Term Follow-Up Studies.

ABSTRACT: Reproductive health is compromised during anorexia nervosa (AN). However, it is still unclear whether this medical complication is reversible after recovery from AN. The purpose of this paper was to conduct a systematic review of the major reproductive health outcomes in females after recovery from AN. The review was conducted in adherence to preferred reporting items for systematic review and meta-analyses (PRISMA) guidelines. Data were collated using meta-analysis and a narrative approach. Of the 1186 articles retrieved, five studies met the inclusion criteria and were reviewed. These studies monitored weight-restored females who had recovered from AN for a follow-up period of between six and 18 years. Their narrative analysis revealed that appropriate treatment of AN leads to the normalization of reproductive function, especially in terms of fertility, pregnancy, and childbirth rates. The meta-analysis confirmed this finding, where the pooled odds of childbirth rates between the AN group and the general population was not statistically significant (OR = 0.75, 95% CI: 0.43-1.29, p = 0.41). We conclude that if patients undergo appropriate eating-disorder treatment and weight restoration, it appears to be unlikely that reproductive health is affected by AN. However, since this finding is derived from only a few studies, it requires replication and confirmation.

SUBMITTER: Chaer R

PROVIDER: S-EPMC7768504 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Fertility and Reproduction after Recovery from Anorexia Nervosa: A Systematic Review and Meta-Analysis of Long-Term Follow-Up Studies.

Chaer Rayane R Nakouzi Nour N Itani Leila L Tannir Hana H Kreidieh Dima D El Masri Dana D El Ghoch Marwan M

Diseases (Basel, Switzerland) 20201216 4

Reproductive health is compromised during anorexia nervosa (AN). However, it is still unclear whether this medical complication is reversible after recovery from AN. The purpose of this paper was to conduct a systematic review of the major reproductive health outcomes in females after recovery from AN. The review was conducted in adherence to preferred reporting items for systematic review and meta-analyses (PRISMA) guidelines. Data were collated using meta-analysis and a narrative approach. Of ...[more]

PMID: 33339411

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Project description:ObjectiveThe current study sought to examine the predictive validity of the purging disorder diagnosis at long-term follow-up by comparing naturalistic outcomes with bulimia nervosa.MethodWomen with purging disorder (N = 84) or bulimia nervosa (N = 133) who had completed comprehensive baseline assessments as part of one of three studies between 2000 and 2012 were sought for follow-up assessment. Nearly all (94.5%) responded to recruitment materials and 150 (69% of sought sample; 83.3% non-Hispanic white; 33.40 [7.63] years old) participated at an average of 10.59 (3.71) years follow-up. Participants completed the Eating Disorder Examination, the Structured Clinical Interview for DSM-IV, and a questionnaire battery. Diagnostic groups were compared on eating disorder (illness status, recovery status, and eating pathology) and related outcomes. Group differences in predictors of outcome were explored.ResultsThere were no significant differences in eating disorder presence (p = .70), recovery status (p = .87), and level of eating pathology (p = .17) between diagnostic groups at follow-up. Post hoc equivalence tests indicated group differences were smaller than a medium effect size (p's ≤ .005). Groups differed in diagnosis at follow-up (p = .002); diagnostic stability was more likely than cross-over to bulimia nervosa for women with baseline purging disorder (p = .004).DiscussionAlthough purging disorder and bulimia nervosa do not differ in long-term outcomes, the relative stability in clinical presentation suggests baseline group differences in clinical presentation may be useful in augmenting treatments for purging disorder.Public significance statementWhile purging disorder is classified as an "other specified" eating disorder, individuals who experience this disorder have comparable negative long-term outcomes as those with bulimia nervosa. This highlights the importance of screening for and treating purging disorder as a full-threshold eating disorder.

Dataset Information

Fertility and Reproduction after Recovery from Anorexia Nervosa: A Systematic Review and Meta-Analysis of Long-Term Follow-Up Studies.

Publications

Fertility and Reproduction after Recovery from Anorexia Nervosa: A Systematic Review and Meta-Analysis of Long-Term Follow-Up Studies.

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