Eating disorders, pregnancy and the postnatal period: a review of the recent literature

Abstract

Purpose of review Eating disorders (ED) are severe psychiatric disorders that affect women in reproductive age. The purpose of this review is to provide an up-to-date overview of the impact of maternal ED on pregnancy and the postnatal period. The clinical implications for identification and management of maternal ED are also discussed. Recent findings In the last 2 years, 15 articles focused on the impact of maternal ED in pregnancy and postpartum. Findings from this review indicate that around 15% of pregnant women are likely to have had an ED at some point in their lifetime, and about 5% have an ED in pregnancy. Although ED symptoms tend to decrease during pregnancy, remission is often only temporary with symptoms typically resurfacing in the postnatal period. Women with ED are prone to psychiatric comorbidities such as depression and anxiety during the perinatal period, with up to a third of women with ED reporting postnatal depression in clinical studies and prevalence ranging between 40% and 66% in general population samples. Furthermore, recent findings continue to highlight that current and prior history of maternal ED are associated with a heightened risk of adverse pregnancy and birth outcomes, most notably preterm birth and adverse birth weight outcomes. Summary These findings continue to emphasise the clinical importance of early identification and response to maternal ED to mitigate potentially adverse maternal and infant outcomes.

Eating disorder outcomes: findings from a rapid review of over a decade of research

“…The same study also reported birth-related outcomes in women with ED including having a later first birth, pregnancy health concerns, experience of miscarriage or abortion [ 99 ], and women with ED may have increased experience of adverse pregnancy and neonatal outcomes, and lower numbers of children [ 3 ]. For women with a history of ED, ED symptoms tend to alleviate during pregnancy; however, they commonly resurface during the postnatal period, and up to a third of women with ED report postnatal depression [ 103 , 104 ].…”

Perception of the Body Image in Women after Childbirth and the Specific Determinants of Their Eating Behavior: Cross-Sectional Study (Silesia, Poland)

“…Data indicate that approximately 25.0% of psychopathology affects women during the perinatal period, increasing predisposition to the patho-mechanism of nutritional dysfunction and negative clinical picture of the pre-pregnancy period and remaining latent during this period. On the other hand, in the postpartum phase, it intensifies the progression of previously diagnosed eating disorders, manifesting itself, for example, in the form of vomiting with a frequency of about 30.0% [ 51 , 52 , 53 , 54 , 55 , 56 ]. Eating disorders in the form of anorexia nervosa (anorexia nervosa), bulimia (negative caloric balance), and targeted overweight and obesity (positive caloric balance) exacerbate destructive changes in women’s behavior.…”

Screening instruments for eating disorders in pregnancy: Current evidence, challenges, and future directions

“…Screening for active and previous EDs in pregnant women is important clinically due to comparably high prevalence (Bye et al, 2020; Easter et al, 2013; Watson et al, 2013) and potential adverse outcomes of EDs during and following pregnancy for mother and child (Bye et al, 2021; Mantel et al, 2020; Micali et al, 2011). The aim of the present article is to outline the knowledge and practice gap on screening pregnant women for EDs, and to discuss current evidence and novel data on different screening approaches aimed at informing recommendations for effective screening.…”

“…The prevalence of EDs during pregnancy ranges between 1.5% and 7.6% (Bye et al, 2020; Easter et al, 2013; Watson et al, 2013), with discrepancies largely attributable to differences in psychometric instruments employed and operationalized diagnostic criteria (Bannatyne et al, 2021; Bye et al, 2018). The prevalence of EDs has been estimated to be around 15% in pregnant women by a recent review (Bye et al, 2021). Even for women with no ED history, pregnancy may be a high‐risk period for the onset of disordered eating symptomatology, and women in stable remission prior to pregnancy have a high relapse rate, especially in the early stages of pregnancy and postpartum (Sollid et al, 2021).…”

“…However, for some pregnancy outcomes and in‐utero developmental trajectories, risk has been shown to be higher in active as compared to previous ED (Doersam et al, 2022; Mantel et al, 2020). Common adverse outcomes comprise miscarriage, prematurity, low‐birth weight, and infant feeding difficulties as well as negative consequences for child development (Bye et al, 2021; Mantel et al, 2020; Micali et al, 2011).…”