Attitudes toward weight gain during pregnancy: Results from the Norwegian mother and child cohort study (MoBa)

Abstract

Objective-To explore attitudes toward weight gain during pregnancy in women with and without eating disorders and across eating disorder subtypes, and to examine associations among weight-gain attitudes and actual gestational weight gain, infant birth weight, and infant size-forgestational-age. (35,929) enrolled in the prospective population-based Norwegian Mother and Child Cohort Study (MoBa) provided information at approximately week 18 of gestation regarding eating disorders and weight gain attitudes. We explored these variables in women with anorexia nervosa (AN), bulimia nervosa (BN), eating disorder not otherwise specified, purging type (EDNOS-P), and binge eating disorder (BED). Method-Pregnant womenResults-The presence of an eating disorder as associated with greater worry over gestational weight gain. In women without eating disorders, greater worry was associated with higher gestational weight gain, higher infant weights, greater likelihood of a large-for-gestational-age infant, and reduced likelihood of a small-for-gestational-age infant. Women with BED who reported greater worry also experienced higher weight gains during pregnancy.Conclusion-Women with eating disorders tend to experience weight-gain-related worry during pregnancy. Early worry about gestational weight-gain may be a harbinger of high gestational gain. Keywordsgestational weight gain; anorexia nervosa; bulimia nervosa; binge eating disorderThe past decade has witnessed a growing literature on pregnancy and birth outcomes in women with eating disorders.1 -9 This interest is well founded, since both insufficient and NIH Public Access Author ManuscriptInt J Eat Disord. Author manuscript; available in PMC 2010 July 1. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript excessive gestational weight gain can adversely affect maternal and infant well-being.10 -12 Pregnant women with either a history of an eating disorder or an active eating disorder during pregnancy have been reported to be at increased risk of miscarriage, preterm birth, cesarean-section delivery, postpartum depression, and having a low birth weight infant,1 -7 although findings do vary depending on the sample studied.8 , 9 The increased risk of adverse outcomes in women with eating disorders may be partially explained by low prepregnancy body mass index (BMI)5 or by active or sub-threshold symptomatology during pregnancy.2 , 6Although attention has been paid to actual weight gain during pregnancy, less is known about women's attitudes toward weight gain during pregnancy, and the relation between these attitudes and pregnancy outcomes, both in healthy women and in women with eating disorders. No association has been found between attitudes toward weight gain as measured by scores on the Pregnancy and Attitude to Weight Gain Scale,13 and the actual amount of weight gain during pregnancy in samples of healthy adolescents13 and in adult women.14 Healthy pregnant women have been observed to have lower body dissatisfaction scores, fewer weight con...

The experience of pregnancy in women with a history of anorexia nervosa: An interpretive phenomenological analysis

“…In particular, a large study which assessed symptoms in AN in detail found that behaviour tends to change but cognitive/emotional symptoms remain high . Some healthy pregnant women also have high levels of concern about their weight and shape (Swann et al, 2009), and these also tend to be stable during pregnancy (Duncombe et al, 2008). This parallels the stability in our sample, although concerns are clearly greater in those with AN .…”

“…Historically, such changes were considered unimportant (Earle, 2003). Although little researched, work now suggests many pregnant women are very worried about their weight and shape (Swann et al, 2009). Although findings are inconsistent, as pre-existing concerns may alter in various ways, it appears that worries about weight and shape rarely disappear if previously present (Duncombe, Wertheim, Skouteris, Paxton & Kelly, 2008).…”

Eating Disorders and Trauma History in Women with Perinatal Depression

“…11,41 Moreover, perinatal complications associated with a lifetime ED diagnosis include an increased risk for hyperemesis, 13,42 smoking during pregnancy, 43 lower birth weight, and birth defects such as cleft palate and neural tube defects, microcephaly, preterm delivery, and cesarean delivery. 12,16,40,[44][45][46][47] Trauma and abuse history in eating disorders and perinatal depression Women with lifetime histories of EDs are also more likely to report a history of childhood sexual abuse and physical abuse compared with women with no ED history.…”

Atitudes alimentares e para com o ganho de peso e satisfação corporal de gestantes adolescentes

“…Embora não seja formalmente reconhecida a ocorrência de TA na gestação, sugere-se que seja menos comum do que na população em geral 9 . Alguns estudos exploraram a presença desses transtornos nessa fase da vida, bem como a preocupação com o ganho de peso na gravidez [10][11][12][13] . A compulsão alimentar é o comportamento inadequado mais relatado durante o período gestacional, e geralmente é acompanhado de ganho de peso excessivo.…”

“…Gestantes com TCA têm bebês com maior peso, grandes para a idade gestacional, e apresentam maior risco de parto cirúrgico -desfecho indiretamente influenciado pelo ganho excessivo de peso materno 11 . Tal ganho associado ao TCA durante a gestação representa maior risco de retenção de peso no pós-parto, obesidade, problemas com a imagem corporal e comprometimento da saúde da mãe e da criança 13 . Devido ao fato de que muitas mulheres durante a gestação tentam controlar o peso com a adoção de méto-dos inadequados, é fundamental diagnosticar um TA na gravidez.…”