Course and predictors of maternal eating disorders in the postpartum period

Abstract

Objective To investigate course and predictors of eating disorders in the postpartum period. Method A total of 77,807 women, participating in the Norwegian Mother and Child Cohort Study (MoBa), completed questionnaires during pregnancy including items covering DSM-IV criteria for pre-pregnancy anorexia nervosa (AN), bulimia nervosa (BN), eating disorder not otherwise specified (EDNOS-P), and binge eating disorder (BED). Additional questionnaires were completed at 18 and 36 months postpartum. Results Proportions of women remitting at 18 months and 36 months postpartum were 50% and 59% for AN, 39% and 30% for BN, 46% and 57% for EDNOS-P, and 45% and 42% for BED, respectively. However, disordered eating persisted in a substantial proportion of women meeting criteria for either full or subthreshold eating disorders. BN during pregnancy increased the risk for continuation of BN. BMI and psychological distress were significantly associated with course of BED. Discussion This is the first large-scale population-based study on course of eating disorders in the postpartum period. The results indicated that disordered eating persists in a substantial proportion of women with pre-pregnancy eating disorders. Health care professionals working with women in this phase of life need to pay specific attention to eating disorder symptoms and behaviors.

Eating disorders, pregnancy, and the postpartum period:Findings from the Norwegian Mother and Child Cohort Study (MoBa)

“…MoBa research has yielded insight into the trajectory of illness from pre-pregnancy to during pregnancy and postpartum (13, 15, 18). Similar to the MoBa findings, remission from BN in pregnancy has been noted in previous literature (8, 19), as have incident eating disorders (20).…”

Risk behaviors for eating disorders and depressive symptoms: a study of female adolescents in Juiz de Fora, Minas Gerais State, Brazil

“…Risk behaviors for eating disorders are considered harmful to health 2,3 . Evidence suggests prevalence of risk behaviors for eating disorders ranging from 15% to 25% of the world population 4,5 , and this prevalence appears to be higher in adolescents 1,6 , especially in girls 7,8 .…”

“…Several biological and hereditary factors can be associated with risk behaviors for eating disorders in adolescents. Biological factors include genetic coding and the serotoninergic system 2,4 . Thus, young people with given genes and/or elevated serotonin secretion can be vulnerable to risk behaviors for eating disorders.…”

“…The authors suggest depressive symptoms as possible predictors of risk behaviors for eating disorders. Despite empirical evidence of the relationship between depressive symptoms and risk behaviors for eating disorders 3,4 , a search of some descriptors ("depression", "eating disorders", and "eating behaviors") in the main sites for scientific articles (SciELO, Scopus, Web of Science, and MEDLINE) failed to identify any such studies of Brazilian adolescent girls. This gap highlights the need to develop such a study in this population group.…”

Obstetric and gynecologic problems associated with eating disorders

“…Additionally, incident BN during the first trimester was significantly associated with symptoms of anxiety, depression, low self‐esteem, and low life satisfaction, whereas remission of BED symptoms was significantly associated with higher self‐esteem and greater life satisfaction . Those with onset of BED during pregnancy are more likely to have remission, but higher BMI and psychological distress were associated with continuation of BED and from crossing over from BED to BN …”