Systematic Review of Literature on Eating Disorders During Pregnancy—Risk and Consequences for Mother and Child

Abstract

Background: Eating disorders (ED) are a diagnostic category that includes several nosological units such as anorexia nervosa (AN), bulimia nervosa (BN), or binge eating disorder (BED). This category most often concerns women, while the peak incidence falls on the reproductive age. Therefore the issue of ED during pregnancy is an interesting topic. Due to the creation of unrealistic ideal of “desired,” slim figure both by the mass media and social media even during and right after gestation, more and more pregnant women introduce behaviours aimed at maintaining the “perfect” appearance. However in some cases it may have serious consequences for the health of both mother and child leading to the creation of the term “pregorexia” by the media to describe this issue.Aim: The aim of this paper was to conduct a systematic review of the literature dealing with eating disorders in pregnant women, with particular emphasis on pregorexia.Method: A systematic review of literature published within the last 5 years (2016–2021) in English or Polish and available through MEDLINE / PubMed, Google Scholar and Cochrane Library databases was conducted based on the previously assumed inclusion and exclusion criteria.Results: Initially, 634 publications were obtained during the review, of which 55 papers were selected in the course of the title analysis. After further evaluation of abstracts, 28 papers were qualified for full text analysis. Ultimately, 10 papers were selected for the final analysis.Conclusions: The issue of ED in pregnant women is a broad topic covering a heterogeneous group of women—both those with a previous history and those with the onset during pregnancy. The occurrence of ED symptoms during this period is associated with a high likelihood of negative consequences for both the mother and the child. The course of pregnancies and deliveries in these patients is more complicated. Therefore, it seems reasonable to develop a multidisciplinary screening strategy and standards of management and supervision over this group of patients.

Bodies out of control: Relapse and worsening of eating disorders in pregnancy

“…This finding is consistent with previous findings that eating disorders are more prevalent during pregnancy than in other periods of life ( Smink et al, 2012 ; Easter et al, 2013 ; Pettersson et al, 2016 ; Hecht et al, 2022 ), that pregnancy, psychologically as well as physically, can be an extremely challenging time for women with an eating disorder ( Claydon et al, 2018 ), that stress around pregnancy and facing parenthood may produce an uncontrollable urge to restrict weight gain ( Patel et al, 2005 ), that women with a prior history of eating problems may find it difficult to adjust to their changing body ( Freizinger et al, 2010 ), that eating disordered behaviors from previous years may return ( Mitchell-Gieleghem et al, 2002 ; Ward, 2008 ; Koubaa et al, 2015 ), and of a high incidence of symptomatic relapse in women with an eating disorder ( Sollid et al, 2004 ; Coker et al, 2013 ; Makino et al, 2020 ; Janas-Kozik et al, 2021 ). Our finding agrees also well with the finding that pregnancy is vulnerable period for women’s mental well-being ( Eberhard-Gran et al, 2014 ; Hahn-Holbrook et al, 2018 ).…”

“…Eating disorders in pregnancy is associated with poor outcomes for both the mother and her baby, including miscarriage, preterm delivery, and fetal disabilities such as poor fetal growth or malformations ( Watson et al, 2017 ; Janas-Kozik et al, 2021 ). The overall aim of this study is to understand how women with a history of eating disorder may experience pregnancy.…”

“…The prevalence of eating disorders during pregnancy is rapported being between 5% and 8% ( Easter et al, 2013 ; Pettersson et al, 2016 ). Some studies have found high incidence of symptomatic relapse in women with an eating disorder ( Sollid et al, 2004 ; Crow et al, 2008 ; Coker et al, 2013 ; Makino et al, 2020 ; Janas-Kozik et al, 2021 ). Ward (2008) showed that some women develop eating disorders for the first time during pregnancy, whereas others with a prior history can relapse.…”

Association of Eating Disorders in Prenatal and Perinatal Women and Its Complications in Their Offspring

“…It has been determined that there were no variations in breastfeeding onset and cessation between females suffering from eating disorders and healthy mothers [25]. The related complications are depicted in Above mentioned are the complications of eating disorders in pregnant women and their newborns [26].…”

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

“…On the other hand, some women may experience anxiety, dissatisfaction with weight gain, and worry; this is most often the case for women whose occupation is related to physical appearance. The danger arises when a woman decides to lose weight during pregnancy and exercise too much, which can cause pregnancy complications and negatively affect the health of the baby [ 14 , 15 , 16 , 17 , 18 , 19 ].…”