Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-05T14:03:51.721Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  20 November 2012

H. J. Watson ,
A. Von Holle ,
R. M. Hamer ,
C. Knoph Berg ,
L. Torgersen ,
P. Magnus ,
C. Stoltenberg ,
P. Sullivan ,
T. Reichborn-Kjennerud  and
C. M. Bulik
H. J. Watson
Affiliation:
Centre for Clinical Interventions, Department of Health in Western Australia, Northbridge, WA, Australia Eating Disorders Program, Princess Margaret Hospital for Children, Department of Health in Western Australia, Subiaco, WA, Australia School of Paediatrics and Child Health, The University of Western Australia, Nedlands, WA, Australia
A. Von Holle
Affiliation:
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
R. M. Hamer
Affiliation:
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
C. Knoph Berg
Affiliation:
Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway
L. Torgersen
Affiliation:
Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway
P. Magnus
Affiliation:
Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
C. Stoltenberg
Affiliation:
Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway
P. Sullivan
Affiliation:
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
T. Reichborn-Kjennerud
Affiliation:
Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway Department of Psychiatry, University of Oslo, Oslo, Norway
C. M. Bulik*
Affiliation:
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
*
*Address for correspondence: C. Bulik, Ph.D., Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive, CB#7160, Chapel Hill, North Carolina 27599-7160, USA. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

We internally validated previously published rates of remission, continuation and incidence of broadly defined eating disorders during pregnancy in the Norwegian Mother and Child Cohort (MoBa) at the Norwegian Institute of Public Health.

Method

A total of 77 267 pregnant women enrolled at 17 weeks gestation between 2001 and 2009 were split into a training sample (n = 41 243) from the version 2 dataset and a validation sample (n = 36 024) from the version 5 dataset who were not in the original study. Internal validation of original rate models involved fitting a calibration model to compare model parameters between the two samples and bootstrap estimates of bias in the entire version 5 dataset.

Results

Remission, continuation and incidence estimates remained stable. Pre-pregnancy prevalence estimates in the validation sample were: anorexia nervosa (AN; 0.1%), bulimia nervosa (BN; 1.0%), binge eating disorder (BED; 3.3%) and eating disorder not otherwise specified-purging disorder (EDNOS-P; 0.1%). In early pregnancy, estimates were: BN (0.2%), BED (4.8%) and EDNOS-P (<0.01%). Incident BN and EDNOS-P during pregnancy were rare. The highest rates were for full or partial remission for BN and EDNOS-P and continuation for BED.

Conclusions

We validated previously estimated rates of remission, continuation and incidence of eating disorders during pregnancy. Eating disorders, especially BED, during pregnancy were relatively common, occurring in nearly one in every 20 women. Pregnancy was a window of remission from BN but a window of vulnerability for BED. Training to detect eating disorders by obstetricians/gynecologists and interventions to enhance pregnancy and neonatal outcomes warrant attention.

Keywords

Eating disordersepidemiologyincidenceNorwegian Mother and Child Cohort Studypregnancyprospective studiesremission
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 8 , August 2013 , pp. 1723 - 1734
Copyright
Copyright © Cambridge University Press 2012 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abraham, S, King, W, Llewellyn-Jones, D (1994). Attitudes to body weight, weight gain and eating behavior in pregnancy. Journal of Psychosomatic Obstetrics and Gynecology 15, 189–195.CrossRefGoogle ScholarPubMed
Altman, DG, Vergouwe, Y, Royston, P, Moons, KG (2009). Prognosis and prognostic research: validating a prognostic model. BMJ 338, b605.CrossRefGoogle ScholarPubMed
APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Association: Washington, DC.Google Scholar
Blais, MA, Becker, AE, Burwell, RA, Flores, AT, Nussbaum, KM, Greenwood, DN, Ekeblad, ER, Herzog, DB (2000). Pregnancy: outcome and impact on symptomatology in a cohort of eating-disordered women. International Journal of Eating Disorders 27, 140–149.3.0.CO;2-E>CrossRefGoogle Scholar
Bulik, C, Sullivan, P, Fear, J, Pickering, A, Dawn, A (1999). Fertility and reproduction in women with anorexia nervosa: a controlled study. Journal of Clinical Psychiatry 2, 130–135.CrossRefGoogle Scholar
Bulik, CM, Von Holle, A, Hamer, R, Knoph Berg, C, Torgersen, L, Magnus, P, Stoltenberg, C, Siega-Riz, AM, Sullivan, P, Reichborn-Kjennerud, T (2007). Patterns of remission, continuation and incidence of broadly defined eating disorders during early pregnancy in the Norwegian Mother and Child Cohort Study (MoBa). Psychological Medicine 37, 1109–1118 [Corrigendum, Psychological Medicine 42, 893].CrossRefGoogle ScholarPubMed
Crow, SJ, Agras, WS, Crosby, R, Halmi, K, Mitchell, JE (2008). Eating disorder symptoms in pregnancy: a prospective study. International Journal of Eating Disorders 41, 277–279.CrossRefGoogle ScholarPubMed
Crow, SJ, Keel, PK, Thuras, P, Mitchell, JE (2004). Bulimia symptoms and other risk behaviors during pregnancy in women with bulimia nervosa. International Journal of Eating Disorders 36, 220–223.CrossRefGoogle ScholarPubMed
Efron, B, Tibshirani, R (1993). An Introduction to the Bootstrap. Chapman & Hall/CRC: Boca Raton.CrossRefGoogle Scholar
Fairburn, CG, Welch, SL (1990). The impact of pregnancy on eating habits and attitudes to shape and weight. International Journal of Eating Disorders 9, 153–160.3.0.CO;2-8>CrossRefGoogle Scholar
Good, PI (2006). Resampling Methods: A Practical Guide to Data Analysis. Birkhäuser: Boston.Google Scholar
Götestam, KG, Agras, WS (1995). General population-based epidemiological study of eating disorders in Norway. International Journal of Eating Disorders 18, 119–126.3.0.CO;2-U>CrossRefGoogle ScholarPubMed
Harris, JR, Magnus, P, Tambs, K (2002). The Norwegian Institute of Public Health Twin Panel: a description of the sample and program of research. Twin Research 5, 415–423.CrossRefGoogle Scholar
Knoph Berg, C, Bulik, CM, Von Holle, A, Torgersen, L, Hamer, R, Sullivan, P, Reichborn-Kjennerud, T (2008). Psychosocial factors associated with broadly defined bulimia nervosa during early pregnancy: findings from the Norwegian Mother and Child Cohort Study. Australian and New Zealand Journal of Psychiatry 42, 396–404.CrossRefGoogle ScholarPubMed
Knoph Berg, C, Torgersen, L, Von Holle, A, Hamer, RM, Bulik, CM, Reichborn-Kjennerud, T (2011). Factors associated with binge eating disorder in pregnancy. International Journal of Eating Disorders 44, 124–133.CrossRefGoogle ScholarPubMed
Koubaa, S, Hallstrom, T, Lindholm, C, Hirschberg, AL (2005). Pregnancy and neonatal outcomes in women with eating disorders. Obstetrics and Gynecology 105, 255–260 [Erratum, Obstetrics and Gynecology 111, 1217 (note: Kouba, Saloua corrected to Koubaa, Saloua)].CrossRefGoogle ScholarPubMed
Lacey, JH, Smith, G (1987). Bulimia nervosa: the impact of pregnancy on mother and baby. British Journal of Psychiatry 150, 777–781.CrossRefGoogle ScholarPubMed
Leddy, MA, Jones, C, Morgan, MA, Schulkin, J (2009). Eating disorders and obstetric-gynecologic care. Journal of Women's Health 18, 1395–1401.CrossRefGoogle ScholarPubMed
Lemberg, R, Phillips, J (1989). The impact of pregnancy on anorexia nervosa and bulimia. International Journal of Eating Disorders 8, 285–295.3.0.CO;2-P>CrossRefGoogle Scholar
Magnus, P, Irgens, LM, Haug, K, Nystad, W, Skjaerven, R, Stoltenberg, C, MoBa Study Group (2006). Cohort profile: The Norwegian Mother and Child Cohort Study (MoBa). International Journal of Epidemiology 35, 1146–1150.CrossRefGoogle ScholarPubMed
Mazzeo, SE, Zucker, NL, Gerke, CK, Mitchell, KS, Bulik, CM (2005). Parenting concerns of women with histories of eating disorders. International Journal of Eating Disorders 37 (Suppl.), S77–S79, discussion S87–S89.CrossRefGoogle ScholarPubMed
Micali, N, Simonoff, E, Treasure, J (2007 b). Risk of major adverse perinatal outcomes in women with eating disorders. British Journal of Psychiatry 190, 255–259.CrossRefGoogle ScholarPubMed
Micali, N, Treasure, J, Simonoff, E (2007 a). Eating disorders symptoms in pregnancy: a longitudinal study of women with recent and past eating disorders and obesity. Journal of Psychosomatic Research 63, 297–303.CrossRefGoogle ScholarPubMed
Nickols-Richardson, SM (2008). Anorexia nervosa and bulimia nervosa during pregnancy. In Handbook of Nutrition and Pregnancy (ed. Lammi-Keefe, C. J., Couch, S. C. and Philipson, E. H.), pp. 115–134. Humana Press: Totowa, NJ.CrossRefGoogle Scholar
Reba-Harrelson, L, Von Holle, A, Hamer, RM, Torgersen, L, Reichborn-Kjennerud, T, Bulik, CM (2010). Patterns of maternal feeding and child eating associated with eating disorders in the Norwegian Mother and Child Cohort Study (MoBa). Eating Behaviors 11, 54–61.CrossRefGoogle ScholarPubMed
Reichborn-Kjennerud, T, Bulik, CM, Kendler, KS, Røysamb, E, Maes, H, Tambs, K, Harris, JR (2003). Gender differences in binge-eating: a population-based twin study. Acta Psychiatrica Scandinavica 108, 196–202.CrossRefGoogle ScholarPubMed
Reichborn-Kjennerud, T, Bulik, CM, Kendler, KS, Røysamb, E, Tambs, K, Torgersen, S, Harris, JR (2004 a). Undue influence of weight on self-evaluation: a population-based twin study of gender differences. International Journal of Eating Disorders 35, 123–135.CrossRefGoogle ScholarPubMed
Reichborn-Kjennerud, T, Bulik, CM, Tambs, K, Harris, JR (2004 b). Genetic and environmental influences on binge eating in the absence of compensatory behaviors: a population-based twin study. International Journal of Eating Disorders 36, 307–314.CrossRefGoogle ScholarPubMed
Rocco, PL, Orbitello, B, Perini, L, Pera, V, Ciano, RP, Balestrieri, M (2005). Effects of pregnancy on eating attitudes and disorders: a prospective study. Journal of Psychosomatic Research 59, 175–179.CrossRefGoogle ScholarPubMed
Siega-Riz, AM, Haugen, M, Meltzer, HM, Von Holle, A, Hamer, R, Torgersen, L, Knopf-Berg, C, Reichborn-Kjennerud, T, Bulik, CM (2008). Nutrient and food group intakes of women with and without bulimia nervosa and binge eating disorder during pregnancy. American Journal of Clinical Nutrition 87, 1346–1355.CrossRefGoogle ScholarPubMed
Soares, RM, Nunes, MA, Schmidt, MI, Giacomello, A, Manzolli, P, Camey, S, Buss, C, Drehmer, M, Melere, C, Hoffman, J, Ozcariz, S, Manenti, CN, Pinheiro, AP, Duncan, BB (2009). Inappropriate eating behaviors during pregnancy: prevalence and associated factors among pregnant women attending primary care in southern Brazil. International Journal of Eating Disorders 42, 387–393.CrossRefGoogle ScholarPubMed
Sollid, CP, Wisborg, K, Hjort, J, Secher, NJ (2004). Eating disorder that was diagnosed before pregnancy and pregnancy outcome. American Journal of Obstetrics and Gynecology 190, 206–210.CrossRefGoogle ScholarPubMed
Steyerberg, EW (2009). Clinical Prediction Models: A Practical Approach to Development, Validation, and Updating (Statistics for Biology and Health). Springer: New York.CrossRefGoogle Scholar
Steyerberg, EW, Borsboom, GJJM, van Houwelingen, HC, Eijkemans, MJC, Habbema, JDF (2004). Validation and updating of predictive logistic regression models: a study on sample size and shrinkage. Statistics in Medicine 23, 2567–2586.CrossRefGoogle Scholar
Tiller, J, Treasure, J (1998). Eating disorders precipitated by pregnancy. European Eating Disorders Review 6, 178–187.3.0.CO;2-Y>CrossRefGoogle Scholar
Zachrisson, HD, Vedul-Kjelsås, E, Götestam, KG, Mykletun, A (2008). Time trends in obesity and eating disorders. International Journal of Eating Disorders 41, 673–680.CrossRefGoogle ScholarPubMed