{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T12:05:59Z","timestamp":1791115559764,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,10,30]],"date-time":"2013-10-30T00:00:00Z","timestamp":1383091200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research (NIHR)","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"crossref"}]},{"name":"UK National Health Service (NHS)"},{"DOI":"10.13039\/501100000276","name":"UK Department of Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000276","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate fertility treatment, twin births, and unplanned pregnancies in pregnant women with eating disorders in a population\u2010based sample.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A longitudinal population\u2010based birth cohort (Generation\u00a0R).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Rotterdam, the Netherlands.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Sample<\/jats:title>\n                    <jats:p>\n                      Women from the Generation\u00a0R study who reported a history of (recent or past) anorexia nervosa (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0160), bulimia nervosa (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0265), or both (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0130), and a history of psychiatric disorders other than eating disorders (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a01396) were compared with women without psychiatric disorders (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a04367).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Women were compared on the studied outcomes using logistic regression. We performed crude and adjusted analyses (adjusting for relevant confounding factors).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Fertility treatment, twin births, unplanned pregnancies, and women's feelings towards unplanned pregnancies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Relative to women without psychiatric disorders, women with bulimia nervosa had increased odds (odds ratio,\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      , 2.3; 95%\u00a0confidence interval, 95%\u00a0\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      , 1.1\u20135.2) of having undergone fertility treatment. Women with all eating disorders had increased odds of twin births (anorexia nervosa,\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      \u00a02.7, 95%\u00a0\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      1.0\u20137.7; bulimia nervosa,\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      \u00a02.7, 95%\u00a0\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      1.1\u20136.6; anorexia and bulimia nervosa,\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      \u00a03.795%\u00a0\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      1.3\u201310.7). Anorexia nervosa was associated with increased odds of unplanned pregnancies (\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      \u00a01.8, 95%\u00a0\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      1.2\u20132.6) and mixed feelings about these pregnancies (adjusted\u00a0\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      \u00a05.0, 95%\u00a0\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      1.7\u201314.4). Pre\u2010pregnancy body mass index did not explain the observed associations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Eating disorders are associated with increased odds of receiving fertility treatment and twin births. Women with anorexia nervosa were more likely to have an unplanned pregnancy and have mixed feelings about the unplanned pregnancy. Fertility treatment specialists should be aware that both active and past eating disorders (both anorexia nervosa and bulimia nervosa) might underlie fertility problems.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.12503","type":"journal-article","created":{"date-parts":[[2013,10,29]],"date-time":"2013-10-29T06:01:28Z","timestamp":1383026488000},"page":"408-416","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":57,"title":["Fertility treatment, twin births, and unplanned pregnancies in women with eating disorders: findings from a population\u2010based birth cohort"],"prefix":"10.1111","volume":"121","author":[{"given":"N","family":"Micali","sequence":"first","affiliation":[{"name":"Behavioural and Brain Sciences Unit UCL Institute of Child Health London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I","family":"dos\u2010Santos\u2010Silva","sequence":"additional","affiliation":[{"name":"Department of Non\u2010Communicable Disease Epidemiology London School of Hygiene and Tropical Medicine London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"De Stavola","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics London School of Hygiene and Tropical Medicine London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Steenweg\u2010de Graaf","sequence":"additional","affiliation":[{"name":"The Generation R Study Group Erasmus Medical Centre Rotterdam the Netherlands"},{"name":"Department of Epidemiology Erasmus Medical Centre Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V","family":"Jaddoe","sequence":"additional","affiliation":[{"name":"The Generation R Study Group Erasmus Medical Centre Rotterdam the Netherlands"},{"name":"Department of Epidemiology Erasmus Medical Centre Rotterdam the Netherlands"},{"name":"Department of Paediatrics Erasmus Medical Centre \u2013 Sophia Children's Hospital Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Hofman","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Erasmus Medical Centre Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"FC","family":"Verhulst","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry and Psychology Erasmus Medical Centre \u2013 Sophia Children's Hospital Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"EAP","family":"Steegers","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Erasmus Medical Centre Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Tiemeier","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Erasmus Medical Centre Rotterdam the Netherlands"},{"name":"Department of Child and Adolescent Psychiatry and Psychology Erasmus Medical Centre \u2013 Sophia Children's Hospital Rotterdam the Netherlands"},{"name":"Department of Psychiatry Erasmus Medical Centre Rotterdam the 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