Disordered eating and the perinatal period: A systematic review and best evidence synthesis of mental health and psychosocial correlates

Abstract

Objective: This paper systematically reviews the literature to date on the relationship between disordered eating and mental health, psychological and social factors during pregnancy and the post-partum period, as well as the direction of associations.Methods: Peer reviewed articles were sourced from seven databases: PsycINFO, CINAHL, Psychology and Behavioural Sciences Collection, Academic Search Complete, Scopus (MEDLINE), Web of Science, and Proquest. A quality review and best evidence synthesis was conducted.Results: The final review included 11 prospective cohort and 14 cross sectional/retrospective studies. According to a synthesis of findings, a strong level of evidence supports an association between disordered eating during pregnancy and depressive and anxiety symptoms during pregnancy. There was also a limited level of evidence for the association between disordered eating and obsessive-compulsive symptoms during pregnancy and between disordered eating and depressive symptoms during the post-partum period.No directions of associations could be determined. Conclusions:On the basis of initial findings, it is recommended that depressive and anxiety symptoms be monitored in conjunction with any disordered eating concerns during perinatal care. Given the significance of the childbearing years to the health and well-being of both mother and infant, further prospective cohort studies in this area are necessitated.

Outcomes for infants whose mothers had an eating disorder in the perinatal period: A systematic review of the evidence

“…Finally, there appears to be a bi‐directional association between breastfeeding and postnatal depression with breastfeeding protecting the mother from depressive symptoms and postnatal depression resulting in higher odds of not initiating or persisting with breastfeeding (Wouk, Stuebe, & Meltzer‐Brody, 2017). This interplay is important for mothers with eating disorders given the high co‐morbidity with depressive symptomatology (Baskin & Galligan, 2019). Breastfeeding promotion and support are important considerations for optimizing the outcomes for mothers with eating disorders and their infants.…”

“…Previous reviews have explored various aspects of perinatal eating disorders, including narrative reviews exploring eating disorders in pregnancy (Cardwell, 2013) or focusing upon infant outcomes (Arnold et al, 2019), although the lack of stated methodology for these reviews means many studies of relevance may have been omitted. A systematic review explored disordered eating as opposed to eating disorder diagnoses, in the perinatal period, which focused on mental health, psychological and social factors for the mother (Baskin & Galligan, 2019). This review found a high prevalence of comorbid depression and anxiety and recommended all aspects of maternal mental health be addressed for women with disordered eating in the perinatal period.…”

Differential Effects of Intuitive and Disordered Eating on Physical and Psychological Outcomes for Women with Young Children

“…Failing to address such problems at these life stages may result in women developing severe clinical disorders at a time characterised by high stress. While the end of pregnancy and early postpartum are high-risk periods for the triggering or worsening of disordered eating, few studies have explored eating disorders in the early parenting period (Baskin & Galligan, 2019).…”

Psychosocial factors, mental health symptoms, and disordered eating during pregnancy

“…The unique patterns of disordered eating during pregnancy has led researchers to investigate what factors may be associated with disordered eating during this period. A recent systematic review of studies investigating the relationships between mental health, psychosocial correlates, and disordered eating discovered a strong level of evidence supporting an association between depressive and anxiety symptoms and increased disordered eating during pregnancy (Baskin & Galligan, ). There was also conflicting evidence on the association between increased disordered eating and several other psychological and social factors, including negative maternal attitudes or beliefs and poor relationship satisfaction, and the authors called for further prospective studies to examine these factors specifically (Baskin & Galligan, ).…”

“…Examining the associations between psychosocial factors and disordered eating at different pregnancy periods is a critical area of investigation that informs what factors increase or decrease the risk of disordered eating and what supports are needed for women with disordered eating, which may ultimately allow antenatal interventions to be targeted to those at risk during the optimal time (Easter et al, ). Moreover, while the association between depressive and anxiety symptoms and disordered eating during pregnancy has been well established, little is known about how depressive and anxiety symptoms work in conjunction with other psychosocial factors (Baskin & Galligan, ). This is important, as addressing disordered eating alone while ignoring any coexisting depressive or anxiety symptoms is likely to have a reduced impact (Micali, Simonoff, & Treasure, ).…”