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Hecht LM, Braciszewski JM, Miller-Matero LR, Ahmedani BK, Kerver JM, Loree AM. Adequacy of prenatal care utilisation and gestational weight gain among women with depression. J Reprod Infant Psychol 2024; 42:222-233. [PMID: 35582731 DOI: 10.1080/02646838.2022.2075544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 05/03/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Depression is common during pregnancy, can elevate risk for excessive or inadequate gestational weight gain (GWG), and is associated with both underutilisation and overutilisation of prenatal care. Whether GWG is associated with adequacy of prenatal care among women with and without depression in the United States is unknown. This study evaluated whether adequacy of prenatal care differed by depression status and GWG. METHODS Data from the Pregnancy Risk Assessment Monitoring System from 1,379,870 women who were pregnant with a singleton and delivered at 37-42 weeks gestation during 2016 to 2018 were included. Depression was self-reported. The Kotelchuck index was used to evaluate adequacy of prenatal care. Maternal weight gain was compared to GWG guidelines. RESULTS Approximately 13.1% of the sample experienced depression during pregnancy. Although those with depression had increased odds of both inadequate and above adequate levels of prenatal care, this association was no longer significant after accounting for demographics, medical comorbidities, and socioeconomic factors. Individuals with inadequate levels of prenatal care with a normal pre-pregnancy body mass index gained less weight during pregnancy. CONCLUSIONS The association between depression and prenatal care utilisation seems driven by demographic, medical comorbidity, and socioeconomic variables. Weight outcomes were associated with inadequate prenatal care utilisation.
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Affiliation(s)
- Leah M Hecht
- Henry Ford Health System, Center for Health Policy and Health Services Research, Detroit, MI, USA
| | - Jordan M Braciszewski
- Henry Ford Health System, Center for Health Policy and Health Services Research, Detroit, MI, USA
- Henry Ford Health System, Behavioral Health, Detroit, MI, USA
| | - Lisa R Miller-Matero
- Henry Ford Health System, Center for Health Policy and Health Services Research, Detroit, MI, USA
- Henry Ford Health System, Behavioral Health, Detroit, MI, USA
| | - Brian K Ahmedani
- Henry Ford Health System, Center for Health Policy and Health Services Research, Detroit, MI, USA
- Henry Ford Health System, Behavioral Health, Detroit, MI, USA
| | - Jean M Kerver
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - Amy M Loree
- Henry Ford Health System, Center for Health Policy and Health Services Research, Detroit, MI, USA
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2
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Çiçekoğlu Öztürk P, Taştekin Ouyaba A. Prevalence and related factors of eating disorders in pregnancy: a systematic review and meta-analysis. Arch Gynecol Obstet 2024; 309:397-411. [PMID: 37162562 DOI: 10.1007/s00404-023-07051-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 04/18/2023] [Indexed: 05/11/2023]
Abstract
PURPOSE To reveal the prevalence of eating disorders (EDs) and related factors in pregnancy. METHODS The search was performed in PubMed, EBSCOhost, Web of Science, Scopus, Google Scholar, and Ovid databases search up to April 3, 2022, using the keywords combination of "(eating disorders OR anorexia nervosa OR bulimia nervosa OR binge eating disorder) AND (pregnancy OR pregnant)". Two researchers independently extracted data from the articles using a standard form. We evaluated the quality of the studies according to the Joanna Briggs Institute assessment tools. RESULTS The prevalence of EDs in pregnant women in the 11 studies involving 2,369,520 pregnant women was ranging between 0.5 and 10.6%. The prevalence of EDs in pregnant women was 4.3% (95% confidence interval 2%-9%; I2 = 99.5%). The prevalence of anorexia nervosa and binge eating disorder during pregnancy shows a statistically significant increase compared to pre-pregnancy, and the prevalence of bulimia nervosa during pregnancy decreases. The prevalence of EDs is higher in pregnant women under 30 years of age, secondary school graduates, married, and with normal BMI. Half of the pregnant women with EDs had anxiety and about one-third of pregnant women had depression. Excessive exercise is observed in 0.7% of pregnant women, fasting in 0.3%, laxative or diuretic use in 0.1%, and self-induced vomiting in 0.6%. CONCLUSIONS This study is important as it is the first systematic review and meta-analysis to reveal the global prevalence of EDs in pregnant women and related factors. Continuing routine screening tests to detect EDs during pregnancy may contribute to taking special preventive measures for risk groups and protecting mother-child health. TRIAL REGISTRATION PROSPERO registration number (CRD42022324721), date of registration: 10/05/2022.
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Affiliation(s)
- Pınar Çiçekoğlu Öztürk
- Department of Psychiatric Nursing, Fethiye Faculty of Health Sciences, Muğla Sıtkı Koçman University, Muğla, Turkey.
| | - Ayşe Taştekin Ouyaba
- Department of Obstetrics and Gynecology Nursing, Faculty of Health Sciences, Afyonkarahisar Health Sciences University, Afyon, Turkey
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Gerges S, Obeid S, Hallit S. Pregnancy through the Looking-Glass: correlates of disordered eating attitudes among a sample of Lebanese pregnant women. BMC Psychiatry 2023; 23:699. [PMID: 37749491 PMCID: PMC10521442 DOI: 10.1186/s12888-023-05205-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 09/19/2023] [Indexed: 09/27/2023] Open
Abstract
INTRODUCTION Despite the risks of gestational disordered eating for both the mother and fetus, research into this subject is scarce within developing countries, particularly in Lebanon. Our study's objective was to delve into the predictors of disordered eating attitudes during pregnancy among a sample of Lebanese pregnant women while assessing the potential mediating effect of body dissatisfaction between psychosocial factors and disordered eating attitudes in pregnancy. METHODS We framed a cross-sectional study, built on self-report measures. Pregnant women of 18 years old and above were recruited from all the Lebanese governorates through an online survey (N = 433). RESULTS The results showed that higher pregnancy-specific hassles (Beta = 0.19), media and pregnant celebrities' influence (Beta = 0.22), and body dissatisfaction (Beta = 0.17) were significantly associated with increased disordered eating attitudes in pregnancy; whereas higher perceived social support (Beta = -0.03), lower socio-economic status (Beta = -0.84), and multigravidity (Beta = -0.96) were significantly associated with less disordered eating attitudes during pregnancy. Body dissatisfaction mediated the association between pregnancy-specific hassles and disordered eating attitudes, and between social appearance concerns and disordered eating attitudes. CONCLUSION Our study highlighted that antenatal care, particularly in Lebanon, should no longer be limited to biological monitoring but rather seek to identify possible eating disorders and mental health threats. Further investigations following longitudinal designs should pursue identifying additional correlates of gestational disordered eating in the clinical context, in furtherance of consolidating screening programs and building targeted treatment strategies.
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Affiliation(s)
- Sarah Gerges
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
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Grajek M, Krupa-Kotara K, Grot M, Kujawińska M, Helisz P, Gwioździk W, Białek-Dratwa A, Staśkiewicz W, Kobza J. Perception of the Body Image in Women after Childbirth and the Specific Determinants of Their Eating Behavior: Cross-Sectional Study (Silesia, Poland). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191610137. [PMID: 36011771 PMCID: PMC9407984 DOI: 10.3390/ijerph191610137] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/29/2022] [Accepted: 08/13/2022] [Indexed: 05/27/2023]
Abstract
Background: Episodes of loss of control over eating during pregnancy affect up to 36% of women during this period. Many women experience natural concerns about weight gain and body-shape changes during pregnancy and the postpartum period, and food cravings and fluctuations in eating patterns during these periods are physiological phenomena. However, pregnancy and the postpartum period may be an additional determinant of eating disorders. Women who perceive their own bodies as significantly deviating from the presented ideal are more likely to experience anxiety/anxiety related to it and also tend to exhibit abnormal eating behaviors. The perception of one’s body figure also plays an important role in maintaining psychological balance Aim: The aim of this study was to assess the perception of body image by postpartum women. The essence of the study was to see if there were psychomarkers associated with lack of control over eating, food restriction, and emotionally motivated eating in the study population. Material and methods: The study was conducted during the fall and winter of 2021. A total of 288 women participated in the study. The age of the subjects ranged from 21 to 45 years. Results: It was found that 198 women (68.8%) were dissatisfied with their current body weight and figure. Respondents with higher post-pregnancy body mass index showed dissatisfaction with their body shape (49.8%; H = 13.042; p = 0.001). Both body satisfaction and BMI level were significant components of the occurrence of pathological phenomena associated with the TFEQ-13 subscales (p < 0.05). Conclusions: Excessive focus on food restriction as well as lack of control over eating had some association with negative self-perception of body image, mainly in the form of body weight dissatisfaction. Eating behaviors showed an association with BMI level and weight satisfaction after pregnancy.
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Affiliation(s)
- Mateusz Grajek
- Department of Public Health, Department of Public Health Policy, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 41-902 Bytom, Poland
| | - Karolina Krupa-Kotara
- Department of Epidemiology, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 41-902 Bytom, Poland
| | - Martina Grot
- Department of Public Health, Department of Public Health Policy, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 41-902 Bytom, Poland
| | - Maria Kujawińska
- Department of Public Health, Department of Public Health Policy, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 41-902 Bytom, Poland
| | - Paulina Helisz
- Department of Public Health, Department of Public Health Policy, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 41-902 Bytom, Poland
| | - Weronika Gwioździk
- Department of Public Health, Department of Public Health Policy, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 41-902 Bytom, Poland
| | - Agnieszka Białek-Dratwa
- Department of Human Nutrition, Department of Dietetics, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 41-808 Zabrze, Poland
| | - Wiktoria Staśkiewicz
- Department of Technology and Food Quality Evaluation, Department of Dietetics, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 41-808 Zabrze, Poland
| | - Joanna Kobza
- Department of Public Health, Department of Public Health Policy, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 41-902 Bytom, Poland
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Bye A, Martini MG, Micali N. Eating disorders, pregnancy and the postnatal period: a review of the recent literature. Curr Opin Psychiatry 2021; 34:563-568. [PMID: 34475353 DOI: 10.1097/yco.0000000000000748] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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.
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Affiliation(s)
- Amanda Bye
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London
| | - Maria Giulia Martini
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London
- Great Ormond Street Institute of Child Health, University College London
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Nadia Micali
- Great Ormond Street Institute of Child Health, University College London
- Department of Psychiatry
- Department of Paediatrics Obstetrics and Gynaecology, University of Geneva, Geneva, Switzerland
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Predicting the change in perinatal disordered eating symptoms: An examination of psychosocial factors. Body Image 2021; 37:162-171. [PMID: 33676305 DOI: 10.1016/j.bodyim.2021.02.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 02/03/2021] [Accepted: 02/07/2021] [Indexed: 11/23/2022]
Abstract
Disordered eating symptoms remain a largely unidentified and unsupported area in perinatal healthcare, particularly as they pertain to women without diagnosed eating disorders. In an Australian prospective cohort study, women aged 18-48, completed questionnaires between: 18-24 weeks gestation (n = 249, T1), 30-32 weeks gestation (n = 151, T2) and 8-10 weeks postpartum (n = 124, T3), measuring disordered eating symptoms, psychosocial factors (attitudes to pregnancy or motherhood, self-compassion, relationship satisfaction and perinatal social support) and mental health factors (depressive or anxiety symptoms). Multilevel linear models examined predictive associations between psychosocial factors at T1 and the change in disordered eating symptoms from T1 to T2 and from T1 to T3, in addition to the moderating effects of pre-pregnancy BMI and pregnancy depressive or anxiety symptoms. Whilst restraint and shape concerns decreased from T1 to T2, restraint, shape and weight concerns increased from T1 to T3. Psychosocial factors at T1 were able to predict the change in some disordered eating symptoms. Moreover, when pre-pregnancy BMI or pregnancy depressive or anxiety symptoms were elevated, the impact of psychosocial factors on disordered eating increased. The findings of this study provide a more complex understanding of disordered eating across the perinatal period, with implications for future interventions and research design.
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O'Loghlen E, Galligan R. Disordered eating in the postpartum period: Role of psychological distress, body dissatisfaction, dysfunctional maternal beliefs and self-compassion. J Health Psychol 2021; 27:1084-1098. [PMID: 33588637 DOI: 10.1177/1359105321995940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The present cross-sectional study tested the affect regulation model of disordered eating for women in the postpartum period, whereby disordered eating is used to cope with psychological distress. Two hundred and two women who had given birth in the last two years completed an online survey of self-report measures of study variables. Path analyses supported the primary hypothesis: negative affect mediated relationships between body dissatisfaction, dysfunctional maternal beliefs, negative components of self-compassion and disordered eating behaviours, particularly binge eating. Results suggest that negative affect plays a central role in postpartum disordered eating. Interventions to address maladaptive emotion regulation strategies, specifically targeting body image distress and self-critical maternal thoughts may improve eating behaviours for this population.
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Floridia M, Masuelli G, Tassis B, Franceschetti L, Savasi VM, Spinillo A, Tamburrini E, Guaraldi G, Dalzero S, Sansone M, Chiodo A, Antoni AMD, Pinnetti C, Liuzzi G, Ravizza M. Weight gain during pregnancy in women with HIV receiving different antiretroviral regimens. Antivir Ther 2021; 25:315-325. [PMID: 33459635 DOI: 10.3851/imp3376] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND No published studies have evaluated in pregnant women with HIV weight gain with different antiretroviral drug classes. METHODS Data from a national cohort study were used. We compared absolute weight gain and occurrence of excessive weight gain in women with HIV who received during pregnancy integrase inhibitors (INSTI), protease inhibitors (PI), or non-nucleoside reverse transcriptase inhibitors (NNRTI). Excessive weight gain was defined according to the Institute of Medicine recommendations. Possible predictors of weight gain were assessed using univariate and multivariate analyses. RESULTS Among 273 cases (PI: 191, NNRTI: 43, INSTI: 39), the mean weight increase was 11.3 kg, and 25.4% of the mothers had an excessive weight increase. No significant differences were found among the three treatment groups for absolute weight increase, occurrence of excessive weight gain, infant birthweight, and other pregnancy and laboratory outcomes. The comparisons of individual drugs, although based on a limited number of cases, suggested no major differences. A significant positive correlation was found between weight gain and CD4+ T-cell increase during pregnancy. In multivariate analyses, drug class and nucleoside backbone were not associated with absolute or excessive weight increase. Excessive weight increase was significantly associated with week of delivery (adjusted odds ratio: 1.74, 95% CI 1.15, 2.63), obesity (5.21, 95% CI 1.85, 14.64), overweight (7.95, 95% CI 3.26, 19.39), recent substance use (5.96, 95% CI 1.13, 31.40) and fasting 2nd trimester hyperglycaemia (3.94, 95% CI 1.14, 13.65). CONCLUSIONS No significant differences in absolute weight change or occurrence of excessive weight gain were found among women with HIV who received during pregnancy different classes of antiretroviral drugs.
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Affiliation(s)
- Marco Floridia
- National Centre for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | - Giulia Masuelli
- Department of Obstetrics and Neonatology, Città della Salute e della Scienza Hospital, and University of Turin, Turin, Italy
| | - Beatrice Tassis
- Obstetrics and Gynecology Unit, Fondazione IRCCS Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Laura Franceschetti
- Department of Obstetrics and Gynecology, University of Brescia, Brescia, Italy
| | - Valeria Maria Savasi
- Department of Obstetrics and Gynaecology, Luigi Sacco Hospital and University of Milan, Milan, Italy
| | - Arsenio Spinillo
- Department of Obstetrics and Gynaecology, IRCCS S. Matteo, Pavia, Italy
| | - Enrica Tamburrini
- Department of Infectious Diseases, Catholic University and Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giovanni Guaraldi
- Department of Medical Specialties, Infectious Diseases Clinic, University of Modena and Reggio Emilia, Modena, Italy
| | - Serena Dalzero
- Department of Obstetrics and Gynaecology, DMSD San Paolo Hospital Medical School, University of Milan, Milan, Italy
| | - Matilde Sansone
- Department of Neurosciences, Reproductive and Dentistry Science, University Federico II, Naples, Italy
| | - Antonella Chiodo
- Department of Surgical Sciences, Division of Gynaecology and Obstetrics, University of Cagliari, Cagliari, Italy
| | - Anna Maria Degli Antoni
- Department of Infectious Diseases and Hepatology, Azienda Ospedaliera di Parma, Parma, Italy
| | | | | | - Marina Ravizza
- Department of Obstetrics and Gynaecology, DMSD San Paolo Hospital Medical School, University of Milan, Milan, Italy
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Baskin R, Galligan R, Meyer D. Disordered eating from pregnancy to the postpartum period: The role of psychosocial and mental health factors. Appetite 2020; 156:104862. [PMID: 32905822 DOI: 10.1016/j.appet.2020.104862] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 09/01/2020] [Accepted: 09/04/2020] [Indexed: 10/23/2022]
Abstract
The postpartum period has been identified as high-risk period for the increase of disordered eating. This study examined the psychosocial factors-attitudes to motherhood, self-compassion and relationship satisfaction- and mental health factors-depressive and anxiety symptoms-associated with this increase. One hundred and fourteen women completed online questionnaires about their eating behaviours between: 18-24 weeks gestation (T1), 30-32 weeks gestation (T2) and 8-10 weeks postpartum (T3). A cluster analysis examined the change of disordered eating from T2 to T3. Multinomial logistic regressions examined which demographic, psychosocial and mental health factors were associated with disordered eating cluster groups, as individual factors and as a combined model of predictors at T1, T2 and T3. Four cluster groups were identified: 'lower disordered eating', 'increasing risk', 'sub-clinical' and 'clinical'. All psychosocial and mental health predictors were individually associated with a risk group, when compared to the lower disordered eating group. However, when combined, only multiparity and higher depressive symptoms were associated with the sub-clinical group. Multiparity, higher pre-pregnancy body mass index and lower self-compassion were associated with the increasing risk group. This study introduces self-compassion as a psychosocial factor worthy of further investigation and application in the field of perinatal disordered eating, with promising avenues for antenatal intervention.
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Affiliation(s)
- Rachel Baskin
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, VIC, 3122, Australia.
| | - Roslyn Galligan
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, VIC, 3122, Australia.
| | - Denny Meyer
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, 3122, Australia.
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