Documenting the course of loss of control over eating prior to, during and after pregnancy among women with pre‐pregnancy overweight and obesity

Donofry, Shannon D.; Emery, Rebecca L.; Kolko, Rachel P.; Germeroth, Lisa J.; Wang, Bang; Cheng, Yu; Levine, Michele D.

doi:10.1002/eat.23454

Cited by 13 publications

(12 citation statements)

References 27 publications

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“…Although racial identity was not a signi cant covariate in the models of LOC predicting GWG outcomes, substantial prior research has documented that pregnant people who identify as Black or African American are at increased risk for adverse obstetric outcomes relative to white pregnant people, in part due to systemic factors such as structural racism that impact access to and quality of prenatal care (Bentley-Lewis et al, 2014; Karlamangla et al, 2005;Ross et al, 2018;Thoma et al, 2019). Relatedly, we have previously documented that rates of LOC during pregnancy only are endorsed by those who identify as Black or African American (Donofry et al, 2021). Thus, LOC may be a potential target for interventions designed to improve Black pregnant people's perinatal health.…”

Section: Discussionmentioning

confidence: 87%

Loss of Control Eating During Pregnancy is Associated With Excessive Gestational Weight Gain Among Individuals With Overweight and Obesity

Levine

Emery

Conlon

et al. 2022

Preprint

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Purpose: Excessive gestational weight gain (GWG) predicts negative health outcomes among individuals with overweight or obesity. Loss of control eating (LOC), the ingestion of food associated with being unable to control eating, is the core psychopathology of binge eating disorders. We evaluated the contribution of LOC to GWG among pregnant individuals with prepregnancy overweight/obesity. Methods: In a prospective longitudinal study, individuals with prepregnancy BMI≥ 25 (N=257) were interviewed monthly to assess LOC and reported demographic, parity and smoking information. GWG was abstracted from medical records. Results: Among individuals with prepregnancy overweight/obesity, 39% endorsed LOC prior to or during pregnancy. After adjusting for factors that have previously been linked to GWG, LOC during pregnancy, uniquely predicted higher GWG and greater likelihood of exceeding GWG recommendations. Participants with prenatal LOC gained 3.14kg (p=0.03) more than did those without LOC during pregnancy and 78.7% (n = 48/61) exceeded IOM guidelines for GWG. The frequency of LOC episodes was also associated with greater weight gain.Conclusions: Prenatal LOC is common among pregnant individuals with overweight/obesity and predicts greater GWG and increased likelihood of exceeding IOM GWG guidelines. LOC may represent a modifiable behavioral mechanism to prevent excessive GWG among individuals at risk for adverse pregnancy outcomes.

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Section: Discussionmentioning

confidence: 87%

Loss of Control Eating During Pregnancy is Associated With Excessive Gestational Weight Gain Among Individuals With Overweight and Obesity

Levine

Emery

Conlon

et al. 2022

Preprint

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“…In our sample, 6.7% of individuals endorsed LOC in the year prior to pregnancy, which is in‐line with rates of preconception LOC in another study (Easter et al, 2013) that assessed LOC at the item level within the year prior to pregnancy. However, rates of preconception LOC tend to be higher in cross‐sectional work that uses semi‐structured interviews (e.g., Donofry et al, 2020), suggesting that the type and timing of methodology used to operationalize LOC may contribute to differences in prevalence. Our methods did not capture infrequent LOC that occurred outside of the yearly window or that was rated as occurring infrequently (e.g., “rarely” or “sometimes” vs. “very often” or “always”), which may contribute to relatively lower base rates of preconception LOC in our sample.…”

Section: Discussionmentioning

confidence: 99%

The association between preconception loss of control over eating and depressive symptom trajectories from childhood through first pregnancy

Magee

Cheng

et al. 2023

Intl J Eating Disorders

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ObjectiveLoss of control over eating (LOC) during pregnancy impacts prenatal health and often co‐occurs with depressive symptoms. However, the role of depression history as a risk factor for LOC prior to pregnancy is unclear; information that is essential for effective prenatal health promotion. We examined the association between trajectories of depressive symptoms from childhood to first pregnancy and preconception LOC.MethodParticipants (N = 1031) were predominantly Black, first‐time mothers enrolled in the population‐based Pittsburgh Girls Study. LOC and depressive symptoms were measured annually. Pre‐pregnancy height and weight, and gestational weight gain data were abstracted from medical records.ResultsThere was a significant difference in age of first conception for Black and White individuals (t = 8.73, df = 976, p < .001). Latent class analysis revealed four and three classes of depressive symptom trajectories for Black and White individuals, respectively. In the entire sample, the high‐changing and moderate‐decreasing classes of depressive symptoms were each associated with lifetime, in preconception year and not in preconception year, LOC (X2 = 56.7, p < .001).DiscussionHigh levels of lifetime depressive symptoms may increase vulnerability to future LOC prior to first pregnancy, suggesting potential targets for interventions to improve maternal health.Public SignificanceBoth depression history and disordered eating behaviors are known to influence prenatal health. The present study revealed associations between high levels of depressive symptoms from childhood through first pregnancy and loss of control over eating that included the year prior to conception. Results highlight potential targets for preconception interventions with relevance for future prenatal health.

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“…The design was a secondary analysis of a previously conducted prospective observational trial during which written informed consent was obtained for trial participation. As previously reported [ 15 , 16 ], the primary observational cohort study was designed to assess the relationship between loss of control over eating, and other psychosocial factors that may be related to gestational weight gain among individuals with obesity prior to pregnancy. Pregnant individuals with self-reported pre-gravid body mass index (BMI) greater than 25 were recruited at the end of the first trimester.…”

Section: Methodsmentioning

confidence: 99%

Association between labor and delivery pain and postpartum pain with symptoms and clinical diagnosis of postpartum depression in patients with overweight and obesity

Rajabaliev

LaSorda

Ibarra

et al. 2022

Arch Gynecol Obstet

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Purpose Childbirth pain has been associated with the risk for postpartum depression. However, existing studies have been limited by the use of depression screening tools as outcomes, and none to date have used a structured clinical interview for DSM-V (SCID), which is considered the gold standard for psychiatric diagnoses. This study aimed to quantify the relationships between labor and postpartum pain and postpartum depression diagnosis detected by SCID, as well as depression symptoms detected by the Center for Epidemiological Studies Depression Scale (CESD) screening tool, among a high-risk cohort. Methods The study was a secondary analysis of a prospective observational study of a cohort of women enriched for high risk for depression, i.e., pregnant women originally enrolled in a prospective study investigating factors leading to excessive gestational weight gain. Subjects were assessed prospectively for depression using both SCID and CESD at the third trimester and at 6 months postpartum. Overweight and obesity were defined as pre-gravid body mass index (BMI) ≥ 25 kg/m2. Both vaginal and cesarean deliveries were included in the cohort. Pain scores (0–10 numeric rating scale) during childbirth and after delivery were correlated with CESD and SCID. Propensity score matching was performed with propensity groups defined as those with low–moderate postpartum pain and those with high postpartum pain. The relationships between pain measures and 6-month postpartum depression diagnosis by SCID, and between pain measures and 6-month postpartum depression symptoms by CESD, were assessed by unweighted logistic regression and by logistic regression weighted by propensity score derived by average treatment effect (ATE) adjusted for baseline covariates. Results There were 237 subjects in the cohort for analysis. Labor and postpartum pain were not associated with depression diagnosis by SCID at 6 months postpartum. However, postpartum pain, but not labor pain, was associated with depressive symptoms on the CESD at 6 months postpartum. Women with higher maximum postpartum pain scores had significantly higher odds of developing clinically significant postpartum depressive symptoms at 6 months, compared to those with lower pain scores in the unweighted model (OR: 1.3, 95% CI 1.0, 1.5; P = 0.005) and ATE-weighted models (OR: 1.2, 95% CI 1.0, 1.5; P = 0.03). Consistent with prior work, SCID and CESD were strongly associated, and 92.9% (13/14) of participants with postpartum depression diagnosis by 6-month SCID also showed high CESD symptomology, P < 0.0001). Conclusions Although labor and postpartum pain were not associated with clinical diagnosis of depression (SCID) at 6 months postpartum, postpartum pain was linked to 6-month postpartum depression symptoms. Depressive symptoms are more likely to be exhibited in women with higher postpartum pain, potentially reflecting poorer birth recovery. The contribution of postpartum pain and depressive symptoms to overall patterns of poor recovery after childbirth should be assessed further.

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Documenting the course of loss of control over eating prior to, during and after pregnancy among women with pre‐pregnancy overweight and obesity

Cited by 13 publications

References 27 publications

Loss of Control Eating During Pregnancy is Associated With Excessive Gestational Weight Gain Among Individuals With Overweight and Obesity

Loss of Control Eating During Pregnancy is Associated With Excessive Gestational Weight Gain Among Individuals With Overweight and Obesity

The association between preconception loss of control over eating and depressive symptom trajectories from childhood through first pregnancy

Association between labor and delivery pain and postpartum pain with symptoms and clinical diagnosis of postpartum depression in patients with overweight and obesity

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