Clinical management of females seeking fertility treatment and of pregnant females with eating disorders

Paslakis, Georgios; Zwaan, Martina de

doi:10.1002/erv.2667

Cited by 18 publications

(15 citation statements)

References 55 publications

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“…For example, fetal magnetoencephalography (fMEG) is a non-invasive method to study fetal brain activity, which has previously revealed evidence that the maternal metabolism might program the fetal brain [60,61]. However, the first step is the adequate assessment and identification of EDs through medical professionals (general practitioner, gynecologist, or fertility specialist), ideally before pregnancy [62]. Paslakis and de Zwaan [62] recently provided clinical recommendations and specific algorithms for the management of pregnant females with EDs and for females with EDs seeking fertility treatment, underlining the importance of an interdisciplinary approach.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Maternal Eating Disorders on Dietary Intake and Eating Patterns during Pregnancy: A Systematic Review

Dörsam¹,

Preißl

Micali

et al. 2019

Nutrients

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Maternal nutrition in pregnancy has a key influence on optimum fetal health. Eating disorders (EDs) during pregnancy may have detrimental effects on fetal growth and the child’s early development. There is limited knowledge concerning the eating behavior, dietary intake and derived nutritional biomarkers as well as the nutrient supplementation in women with EDs during pregnancy. We performed a systematic review according to the PRISMA statement to synthesize current evidence in this field. Of N = 1203 hits, 13 full-texts were included in the qualitative synthesis. While women with current Binge Eating Disorder (BED) showed higher energy and fat intakes during pregnancy, women with a lifetime Anorexia Nervosa (AN), Bulimia Nervosa (BN) or both (AN + BN) had similar patterns of nutrient intake and dietary supplement use as healthy women. There is evidence, that women with a history of EDs have a sufficient diet quality and are more likely to be vegetarian. Dieting and bingeing improved substantially with pregnancy. The highlighted differences in the consumption of coffee/caffeine and artificially sweetened beverages as well as the elevated prevalence of iron deficiency anemia in women with a past or active ED during pregnancy might have an important impact on fetal development.

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Section: Discussionmentioning

confidence: 99%

The Impact of Maternal Eating Disorders on Dietary Intake and Eating Patterns during Pregnancy: A Systematic Review

Dörsam¹,

Preißl

Micali

et al. 2019

Nutrients

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show abstract

“…The best approach for pregnant women with EDs implies a multidisciplinary management comprised of gynecologists, midwives, nutritionists, and mental health professionals working as a team. However, there is an insufficient medical training to openly discuss eating behaviors with the patient (29). Women with EDs do not often disclose this information to clinicians due to fear of stigmatization or misunderstanding.…”

Section: Eds During Pregnancy: Target Therapymentioning

confidence: 99%

“…Recent evidence showed that maternal disordered eating behaviors impact the course of pregnancy and fetal development. Updated reviews of the literature highlighted that the major obstetric and gynecologic complications were infertility, high rate of miscarriage, poor nutrition during pregnancy, hyperemesis gravidarum, cesarean section, preterm delivery, and postpartum depression (27)(28)(29)(30). The most described detrimental effects on fetal development were fetal growth delay, small for gestational age babies and small head circumference, low Apgar score and an increased risk of perinatal mortality (27)(28)(29)(30).…”

Section: Introductionmentioning

confidence: 99%

Eating Disorders During Gestation: Implications for Mother's Health, Fetal Outcomes, and Epigenetic Changes

et al. 2020

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Introduction: Eating disorders (EDs) have increased globally in women of childbearing age, related to the concern for body shape promoted in industrialized countries. Pregnancy may exacerbate a previous ED or conversely may be a chance for improving eating patterns due to the mother's concern for the unborn baby. EDs may impact pregnancy evolution and increase the risk of adverse outcomes such as miscarriage, preterm delivery, poor fetal growth, or malformations, but the knowledge on this topic is limited. Methods: We performed a systematic review of studies on humans in order to clarify the mechanisms underpinning the adverse pregnancy outcomes in patients with EDs. Results: Although unfavorable fetal development could be multifactorial, maternal malnutrition, altered hormonal pathways, low pre-pregnancy body mass index, and poor gestational weight gain, combined with maternal psychopathology and stress, may impair the evolution of pregnancy. Environmental factors such as malnutrition or substance of abuse may also induce epigenetic changes in the fetal epigenome, which mark lifelong health concerns in offspring. Conclusions: The precocious detection of dysfunctional eating behaviors in the pre-pregnancy period and an early multidisciplinary approach comprised of nutritional support, psychotherapeutic techniques, and the use of psychotropics if necessary, would prevent lifelong morbidity for both mother and fetus. Further prospective studies with large sample sizes are needed in order to design a structured intervention during every stage of pregnancy and in the postpartum period.

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“…The findings highlight the importance of consistency in the diagnostic criteria operationalised in studies and support the validation of suitable instruments for use with antenatal populations (Bannatyne, Hughes, Stapleton, Watt, & MacKenzie‐Shalders, ). In a recent article by Paslakis and de Zwaan (Paslakis & Zwaan, ), the lack of appropriate algorithms for identifying ED in pregnant women was highlighted.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and clinical characterisation of pregnant women with eating disorders

Bye

Nath

Ryan

et al. 2020

Euro Eating Disorders Rev

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Objective: To estimate prevalence of lifetime and current eating disorders (ED) in a sample of pregnant women in South-East London and to describe their sociodemographic and clinical characteristics.Method: Secondary analysis of data from a cross-sectional survey. Using a stratified sampling design, 545 pregnant women were recruited. Diagnostic interviews were administered to assess lifetime and current ED, depression, anxiety, and borderline personality disorder. Data were extracted from maternity records to assess identification of ED in antenatal care. Estimates of population prevalence of ED were obtained using sampling weights to account for the stratified sampling design. Results: Weighted prevalence of lifetime ED was 15.35% (95% confidence interval [CI] [11.80, 19.71]), and current ED was 1.47% (95% CI [0.64, 3.35]).Depression, anxiety, and history of deliberate self-harm or attempted suicide were common in pregnant women with ED. Identification of ED in antenatal care was low.Conclusions: Findings indicate that by early pregnancy, a significant proportion of pregnant women will have had ED, although less typically during pregnancy, and psychiatric comorbidity is common. Yet ED were poorly recognised in antenatal care. The findings highlight the importance of increasing aware-Louise M. Howard and Nadia Micali should be considered joint senior authors.

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Clinical management of females seeking fertility treatment and of pregnant females with eating disorders

Cited by 18 publications

References 55 publications

The Impact of Maternal Eating Disorders on Dietary Intake and Eating Patterns during Pregnancy: A Systematic Review

The Impact of Maternal Eating Disorders on Dietary Intake and Eating Patterns during Pregnancy: A Systematic Review

Eating Disorders During Gestation: Implications for Mother's Health, Fetal Outcomes, and Epigenetic Changes

Prevalence and clinical characterisation of pregnant women with eating disorders

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