Gestational and Postpartum Weight Change Patterns in Mothers with Eating Disorders (original) (raw)
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BJOG: An International Journal of Obstetrics & Gynaecology, 2012
Please cite this paper as: Micali N, De Stavola B, dos‐Santos‐Silva I, Steenweg‐de Graaff J, Jansen P, Jaddoe V, Hofman A, Verhulst F, Steegers E, Tiemeier H. Perinatal outcomes and gestational weight gain in women with eating disorders: a population‐based cohort study. BJOG 2012;119:1493–1502.Objective To investigate adverse perinatal outcomes and gestational weight gain trajectories in women with lifetime (current/past) eating disorders (ED: anorexia nervosa [AN] and bulimia nervosa [BN]).Design A longitudinal population‐based birth cohort.Setting Rotterdam, the Netherlands.Sample Women who enrolled prenatally, had complete information on exposure (lifetime ED), and gave birth to a live singleton (n = 5256). Four groups of exposed women: lifetime AN (n = 129), lifetime BN (n = 209), lifetime AN + BN (n = 100), other lifetime psychiatric disorder (n = 1002) were compared with unexposed women (n = 3816).Methods Perinatal outcomes and gestational weight gain were obtained from o...
Journal of Abnormal Psychology, 2017
Previous research suggests that maternal eating disorders are associated with adverse pregnancy, delivery, and neonatal outcomes. In turn, adverse perinatal outcomes have been associated with subsequent eating disorder risk in adult offspring, possibly reflecting a transgenerational cycle of risk. Previous studies of the relationship between maternal eating disorders and adverse perinatal outcomes have failed to control for familial transmission of perinatal event phenotypes, which may confound the association. In a unique design afforded by the Norwegian Mother and Child Cohort Study (MoBa) and Medical Birth Registry of Norway, we linked three generations through birth register records and maternal-reported survey data. The aim was to determine if maternal eating disorders increase risk after parsing out the contribution of familial transmission of perinatal events. The samples were 70,881 pregnancies in grandmother-mother-child triads for analyses concerning eating disorder exposure during pregnancy and 52,348 for analyses concerning lifetime maternal eating disorder exposure. As hypothesized, eating disorders predicted a higher incidence of perinatal complications even after adjusting for grandmaternal perinatal events. For example, anorexia nervosa immediately prior to pregnancy was associated with smaller birth length (relative risk = 1.62, 95% confidence interval = 1.20, 2.14), bulimia nervosa with induced labor (1.21; 1.07, 1.36), and binge-eating disorder with several delivery complications, larger birth length (1.25; 1.17, 1.34), and large-for-gestational-age (1.04; 1.01, 1.06). Maternal pregravid body mass index and gestational weight mediated most associations. Our results support the contention that exposure to eating disorders increases the risk for negative health outcomes in pregnant women and their babies.
European Eating Disorders Review, 2014
This study aims to investigate longitudinal patterns of psychopathology during the antenatal and postnatal periods among women with current (C-ED) and past (P-ED) eating disorders. Women were recruited to a prospective longitudinal study: C-ED (n = 31), P-ED (n = 29) and healthy control (HC; n = 57). Anxiety, depression and ED symptoms were measured at four time points: first/second trimester, third trimester, 8 weeks and 6 months postpartum. Linear mixed effects models were used to test for group differences. Women with C-ED and P-ED, in all diagnostic categories, had significantly higher levels of psychopathology at all time points. ED symptoms decreased in the C-ED group, compared with an overall increase in the other two groups but subsequently increased after pregnancy. Overall, depression and state and trait anxiety scores decreased in the C-ED group compared with the HC group throughout the antenatal and postnatal periods. High levels of psychopathology are common throughout the antenatal and postnatal periods among women with current and past ED, and despite some overall reductions, symptoms remain clinically significant.
Bodies out of control: Relapse and worsening of eating disorders in pregnancy
Frontiers in Psychology
BackgroundBeing pregnant is a vulnerable period for women with a history of eating disorders. A central issue in eating disorders is searching control of one’s body and food preferences. Pregnancy implies being increasingly out of control of this. Treatment and targeted prevention start with the patient’s experience. Little is known about how women with a history of eating disorder experience being pregnant.MethodWe interviewed 24 women with a history of eating disorder at the time of pregnancy, recruited from five public pregnancy controls at local family health centers in Norway. Interviews were analyzed by means of ideal type analysis, with a particular focus on how the participants experienced pregnancy and perceived triggers in possible experiences of relapse or worsening during pregnancy. All participants completed the Eating Disorder Examination Questionnaire (EDE-Q) and were diagnosed (DSM-5) by using the Eating Disorder Examination (EDE).ResultsOn becoming pregnant, 23 of t...
Journal of Psychosomatic Research, 2007
Objective: To determine the impact of pregnancy on eating disorders (ED) symptoms using data from a large prospective, community-based cohort study. Methods: Women (12,254) were classified according to whether they had a recent or past history of ED, were obese before pregnancy, or constituted part of the general population control group. We evaluated self-induced vomiting (SIV), laxative use, exercise behavior, and appraisals about weight gain during pregnancy, as well as dieting, and shape and weight concern before and during pregnancy. Results: Women with a recent episode of ED dieted, used laxatives, reported SIV, and exercised more than other groups during pregnancy. They were also more likely to report ED cognitions in pregnancy and their weight and shape concern scores remained high during pregnancy. Women with past ED were also more likely than controls to have some ED behaviors and/ or concerns about weight gain during pregnancy. Conclusions: Women with a recent ED continued to have some ED symptoms in pregnancy, albeit fewer compared to before pregnancy. Although at a lower level, women with a past history of ED also had ED symptoms in pregnancy. Screening for ED symptoms during pregnancy may provide a useful opportunity for engagement in treatment and to reduce behaviors that might be detrimental to the foetus. D
The effects of eating disorders in pregnancy on mother and baby: a review
Psychiatria Danubina, 2019
The psychological and physiological interaction between anorexia and the pregnant state has a large intrapartum and postpartum impact on mother and baby. Current research has attempted to discern the short and long term effects of eating disorders (EDs) on pregnancy as well as mother and baby-related sequelae; however little is understood about which management strategies are likely to prove most successful in mitigating these risks. The incidence and effect of low pre-pregnancy body mass index (BMI) on obstetric outcomes, and possible health complications in the future child, has attracted widespread attention. Especially concerning is the fact that it has long been known that the incidence of EDs in women of childbearing age is not only the highest out of all age categories but also is on an increasing trajectory. This paper aims to highlight the recent evidence underpinning the management of pregnant women with EDs in the light of the discussed short and long term effects of the ...
Pregnancy, obstetric, and perinatal health outcomes in eating disorders
American Journal of Obstetrics and Gynecology, 2014
Authors JTS and JMS have been involved in a research collaboration with Janssen-Cilag. Author JTS has received fees for giving expert opinions to Lightlake Sinclair and attended one international conference supported by Janssen-Cilag. Author JMS has received a lecturing fee from AstraZeneca. Author JH has been in research collaboration with Janssen-Cilag and Eli Lilly, and has been a member of the expert advisory group for Astellas. Author AR attended a medical seminar supported by Janssen-Cilag. Authors ML and MG have no conflicts of interest to report.
PloS one, 2015
Little is known about medication use among women with eating disorders in relation to pregnancy. To explore patterns of and associations between use of psychotropic, gastrointestinal and analgesic medications and eating disorders in the period before, during and after pregnancy. This study is based on the Norwegian Mother and Child Cohort Study (MoBa). A total of 62,019 women, enrolled at approximately 17 weeks' gestation, had valid data from the Norwegian Medical Birth Registry and completed three MoBa questionnaires. The questionnaires provided diagnostic information on broadly defined anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED) and recurrent self-induced purging in the absence of binge eating (EDNOS-P), along with self-reported use of medication six months before, during, and 0-6 months after pregnancy. The prevalence of eating disorder subtypes before and/or during pregnancy was: 0.09% AN (n = 54), 0.94% BN (n = 585), 0.10% EDNOS-P (n = 61) and 5...