Pregnancy, obstetric, and perinatal health outcomes in eating disorders

Linna, Milla S.; Raevuori, Anu; Haukka, Jari; Suvisaari, Jaana; Suokas, Jaana; Gissler, Mika

doi:10.1016/j.ajog.2014.03.067

Cited by 109 publications

(133 citation statements)

References 52 publications

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“…A metaanalysis showed that ED, particularly anorexia nervosa (AN), is also associated with adverse birth outcomes including low birth-weight (around 0.2Kg less than babies born to non-affected mothers) (Solmi et al, 2014) and babies born small for gestational age (16% of babies born to mothers with AN below the 10 th centile of sex and gestational-specific birthweights) (Micali et al, 2016b). However, opposite findings have been reported for women with bulimia nervosa (BN) and binge eating disorder (BED) having babies large for gestational age (Linna et al, 2014).…”

Section: Risks Related To Eating Disordersmentioning

confidence: 99%

British Association for Psychopharmacology consensus guidance on the use of psychotropic medication preconception, in pregnancy and postpartum 2017

et al. 2017

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Decisions about the use of psychotropic medication in pregnancy are an ongoing challenge for clinicians and women with mental health problems, due to the uncertainties around risks of the illness itself to mother and fetus/infant, effectiveness of medications in pregnancy and risks to the fetus/infant from in utero exposure or via breast milk. These consensus guidelines aim to provide pragmatic advice regarding these issues. They are divided into sections on risks of untreated illness in pregnancy; general principles of using drugs in the perinatal period; benefits and harms associated with individual drugs; and recommendations for the management of specific disorders.

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Section: Risks Related To Eating Disordersmentioning

confidence: 99%

British Association for Psychopharmacology consensus guidance on the use of psychotropic medication preconception, in pregnancy and postpartum 2017

et al. 2017

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“…In Western societies, despite the fact that excessive gestational weight gain is far more common (Gould Rothberg et al, 2011), the consequences of weight gain below the recommendations should be contemplated as well. For instance, women displaying eating disorder symptoms may not be able to reach an adequate gestational weight gain according to their pre-gestational body mass index (Treasure and Russell, 1988; Micali et al, 2007; Institute of Medicine, 2009), which may lead to increased risk of preterm births or delivery of babies of smaller size (Linna et al, 2014). Additionally, in obese and normoweight women, decreased weight gain during pregnancy may reduce the risk of suffering from maternal obstetrical complications but also increase the possibility of newborns small for their gestational age (Kapadia et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Maternal Caloric Restriction Implemented during the Preconceptional and Pregnancy Period Alters Hypothalamic and Hippocampal Endocannabinoid Levels at Birth and Induces Overweight and Increased Adiposity at Adulthood in Male Rat Offspring

Ramírez-López

Vázquez

Bîndilă

et al. 2016

Front. Behav. Neurosci.

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Exposure to inadequate nutritional conditions in critical windows of development has been associated to disturbances on metabolism and behavior in the offspring later in life. The role of the endocannabinoid system, a known regulator of energy expenditure and adaptive behaviors, in the modulation of these processes is unknown. In the present study, we investigated the impact of exposing rat dams to diet restriction (20% less calories than standard diet) during pre-gestational and gestational periods on: (a) neonatal outcomes; (b) endocannabinoid content in hypothalamus, hippocampus and olfactory bulb at birth; (c) metabolism-related parameters; and (d) behavior in adult male offspring. We found that calorie-restricted dams tended to have a reduced litter size, although the offspring showed normal weight at birth. Pups from calorie-restricted dams also exhibited a strong decrease in the levels of anandamide (AEA), 2-arachidonoylglycerol (2-AG), arachidonic acid (AA) and palmitoylethanolamide (PEA) in the hypothalamus at birth. Additionally, pups from diet-restricted dams displayed reduced levels of AEA in the hippocampus without significant differences in the olfactory bulb. Moreover, offspring exhibited increased weight gain, body weight and adiposity in adulthood as well as increased anxiety-related responses. We propose that endocannabinoid signaling is altered by a maternal caloric restriction implemented during the preconceptional and pregnancy periods, which might lead to modifications of the hypothalamic and hippocampal circuits, potentially contributing to the long-term effects found in the adult offspring.

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“…Currently, maternal undernutrition is a problem not exclusive of developing countries. The pressure to thinness in western societies associated to a higher prevalence of women with a past of eating disorders or a worry in excess about body changing during pregnancy and postpartum have raised the risk for giving birth underweight babies (Easter et al, 2013; Linna et al, 2014). However, we should not discard a predictive marker of impaired fetal nutrition in those cases with absence of low birth weight.…”

Section: Introductionmentioning

confidence: 99%

Long-Term Effects of Prenatal Exposure to Undernutrition on Cannabinoid Receptor-Related Behaviors: Sex and Tissue-Specific Alterations in the mRNA Expression of Cannabinoid Receptors and Lipid Metabolic Regulators

Ramírez-López

Arco

Decara

et al. 2016

Front. Behav. Neurosci.

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Maternal malnutrition causes long-lasting alterations in feeding behavior and energy homeostasis in offspring. It is still unknown whether both, the endocannabinoid (eCB) machinery and the lipid metabolism are implicated in long-term adaptive responses to fetal reprogramming caused by maternal undernutrition. We investigated the long-term effects of maternal exposure to a 20% standard diet restriction during preconceptional and gestational periods on the metabolically-relevant tissues hypothalamus, liver, and perirenal fat (PAT) of male and female offspring at adulthood. The adult male offspring from calorie-restricted dams (RC males) exhibited a differential response to the CB1 antagonist AM251 in a chocolate preference test as well as increased body weight, perirenal adiposity, and plasma levels of triglycerides, LDL, VLDL, bilirubin, and leptin. The gene expression of the cannabinoid receptors Cnr1 and Cnr2 was increased in RC male hypothalamus, but a down-expression of most eCBs-metabolizing enzymes (Faah, Daglα, Daglβ, Mgll) and several key regulators of fatty-acid β-oxidation (Cpt1b, Acox1), mitochondrial respiration (Cox4i1), and lipid flux (Pparγ) was found in their PAT. The female offspring from calorie-restricted dams exhibited higher plasma levels of LDL and glucose as well as a reduction in chocolate and caloric intake at post-weaning periods in the feeding tests. Their liver showed a decreased gene expression of Cnr1, Pparα, Pparγ, the eCBs-degrading enzymes Faah and Mgll, the de novo lipogenic enzymes Acaca and Fasn, and the liver-specific cholesterol biosynthesis regulators Insig1 and Hmgcr. Our results suggest that the long-lasting adaptive responses to maternal caloric restriction affected cannabinoid-regulated mechanisms involved in feeding behavior, adipose β-oxidation, and hepatic lipid and cholesterol biosynthesis in a sex-dependent manner.

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Pregnancy, obstetric, and perinatal health outcomes in eating disorders

Cited by 109 publications

References 52 publications

British Association for Psychopharmacology consensus guidance on the use of psychotropic medication preconception, in pregnancy and postpartum 2017

British Association for Psychopharmacology consensus guidance on the use of psychotropic medication preconception, in pregnancy and postpartum 2017

Maternal Caloric Restriction Implemented during the Preconceptional and Pregnancy Period Alters Hypothalamic and Hippocampal Endocannabinoid Levels at Birth and Induces Overweight and Increased Adiposity at Adulthood in Male Rat Offspring

Long-Term Effects of Prenatal Exposure to Undernutrition on Cannabinoid Receptor-Related Behaviors: Sex and Tissue-Specific Alterations in the mRNA Expression of Cannabinoid Receptors and Lipid Metabolic Regulators

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