Anorexia Nervosa and Bulimia Nervosa During Pregnancy

Nickols‐Richardson, Sharon M.

doi:10.1007/978-1-59745-112-3_9

Cited by 1 publication

(1 citation statement)

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“…Lack of training in identification of signs and symptoms, a perception that assessment falls outside the scope of practice, and lack of awareness of the consequences of eating disorders in pregnancy may explain this (Leddy et al 2009). Nevertheless, vigilance for potential signs and symptoms can be easily incorporated into routine ob/gyn practice, via screening questions posed to the individual and through assiduity to selected anthropometric, biochemical, dietary intake, and clinical data, such as reproductive history (Nickols-Richardson 2008). …”

Section: Discussionmentioning

confidence: 99%

Remission, continuation and incidence of eating disorders during early pregnancy: a validation study in a population-based birth cohort

et al. 2012

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Background The objective of this study was to validate previously published rates of remission, continuation, and incidence of broadly defined eating disorders during pregnancy. The previous rate modeling was done by our group (Bulik et al. 2007) and yielded participants halfway into recruitment of the planned 100,000 pregnancies in the Norwegian Mother and Child (MoBa) Cohort at the Norwegian Institute of Public Health. This study aimed to internally validate the findings with the completed cohort. Methods 77267 pregnant women enrolled at 17 weeks gestation between 2001 and 2009 were included. Participants were split into a “training” sample (n=41243) based on participants in the MoBa version 2 dataset of the original study and a “validation” sample (n=36024) comprising individuals in the MoBa version 5 dataset that were not in the original study (Bulik et al. 2007). Internal validation of all original rate models involved fitting a calibration model to compare model parameters between the “training” and “validation” samples as well as bootstrap estimates of bias in the entire version 5 dataset. Results Remission, continuation, and incidence estimates from the “training” sample remained stable when evaluated via a split sample validation procedure. Pre-pregnancy prevalence estimates in the “validation” sample were 0.1% for anorexia nervosa, 1.0% for bulimia nervosa (BN), 3.3% for binge eating disorder (BED), and 0.1% for purging disorder (EDNOS-P). In early pregnancy, estimates were 0.2% for BN, 4.8% for BED, and <0.01% for EDNOS-P. Consistent with the original study, incident BN and EDNOS-P during pregnancy were rare. For BED, the adjusted incidence rate in the “validation” sample was 1.17 per 1000 person-weeks. The highest rates were for full or partial remission for BN and EDNOS-P, and continuation for BED. Conclusions This study provides evidence of validity of previously estimated rates of remission, continuation, and incidence of eating disorders during pregnancy. Eating disorders during pregnancy were relatively common, occurring in nearly 1 in every 20 women, although almost all were cases of BED. Pregnancy was a window of remission from BN but a window of vulnerability for onset and continuation of BED. Training to detect the signs and symptoms of eating disorders by obstetricians/gynecologists and interventions to enhance pregnancy and neonatal outcomes warrant attention.

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Section: Discussionmentioning

confidence: 99%