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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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Stemann Larsen P, Nybo Andersen AM, Olsen EM, Kragh Andersen P, Micali N, Strandberg-Larsen K. Weight trajectories and disordered eating behaviours in 11- to 12-year-olds: A longitudinal study within the Danish National Birth Cohort. EUROPEAN EATING DISORDERS REVIEW 2019; 27:436-444. [PMID: 31016786 DOI: 10.1002/erv.2680] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 03/01/2019] [Accepted: 03/23/2019] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To examine how childhood weight trajectories are associated with disordered eating behaviours (DEBs) in early adolescence. METHODS Self-reports on DEBs (fasting, purging, and binge eating) were obtained from 18,337 children in the 11-year follow-up of the Danish National Birth Cohort. For this population, birth register information on gestational age and birth weight was categorized into the following: small, appropriate, and large for gestational age. Prospective parent-reported height and weight data at child ages 1 and 7 years were dichotomized using standardized cut-offs into non-overweight and overweight. A 12-category weight trajectory variable was created, and the associations between weight trajectory and DEBs were estimated using logistic regression. RESULTS In total, 7.0% 11- to 12-year olds reported DEBs. Compared with children born appropriate for gestational age and being non-overweight at age 1 and 7 years, children born small for gestational age and who were overweight at age 1 and 7 years had a very high risk of disordered eating (OR 7.00; CI [2.57, 19.40]). The statistical analyses revealed, however, that overweight at age 7 years was the main contributor and independently of trajectory increased the risk of disordered eating at age 11-12 years significantly (OR 3.16 CI [2.73, 3.65]). CONCLUSION Overweight not in the first year of life, but at age 7 years was more predictive for DEBs.
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Affiliation(s)
- Pernille Stemann Larsen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anne-Marie Nybo Andersen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Else Marie Olsen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Research Centre for Prevention and Health, Copenhagen University Hospital Glostrup, Capital Region, Copenhagen, Denmark
| | - Per Kragh Andersen
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Nadia Micali
- Great Ormond Street Institute of Child Health, University College London, London, UK.,Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Child and Adolescent Psychiatry Division, Department de l'enfant et de l'adolescent, Geneva University Hospitals, Geneva, Switzerland
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3
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Popovic M, Pizzi C, Rusconi F, Gagliardi L, Galassi C, Trevisan M, Merletti F, Richiardi L. The role of maternal anorexia nervosa and bulimia nervosa before and during pregnancy in early childhood wheezing: Findings from the NINFEA birth cohort study. Int J Eat Disord 2018; 51:842-851. [PMID: 29722053 DOI: 10.1002/eat.22870] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 03/29/2018] [Accepted: 03/31/2018] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study evaluates associations of maternal eating disorders (bulimia nervosa, anorexia nervosa, and purging behaviors) with infant wheezing and examines the effects of eating disorders on several wheezing determinants. METHOD We studied 5,150 singletons from the NINFEA birth cohort. Maternal bulimia nervosa and anorexia nervosa diagnoses were ascertained from the questionnaires completed in pregnancy and 6 months after delivery, and were analyzed as: ever diagnosis, only before pregnancy, and during pregnancy. Purging behaviors were assessed for 12 months before or during pregnancy. The associations with wheezing between 6 and 18 months of age were assessed in models adjusted for a priori selected confounders. RESULTS Children born to mothers with lifetime eating disorders were at an increased risk of developing wheezing (adjusted OR 1.68; [95% CI: 1.08, 2.60]), and this risk further increased when the disorders were active during pregnancy (2.52 [1.23, 5.19]). Increased risk of offspring wheezing was observed also for purging behaviors without history of eating disorder diagnosis (1.50 [1.10, 2.04]). The observed associations were not explained by comorbid depression and/or anxiety. Bulimia nervosa and/or anorexia nervosa during pregnancy were also associated with several risk factors for wheezing, including maternal smoking, adverse pregnancy outcomes, shorter breastfeeding duration, and day-care attendance. DISCUSSION The associations of maternal eating disorders with offspring wheezing suggest long-term adverse respiratory outcomes in children of mothers with eating disorders. A better understanding of mechanisms implicated is necessary to help reduce the respiratory disease burden in these children.
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Affiliation(s)
- Maja Popovic
- Department of Medical Sciences, University of Turin, Turin, Italy.,CPO Piemonte, Turin, Italy
| | - Costanza Pizzi
- Department of Medical Sciences, University of Turin, Turin, Italy.,CPO Piemonte, Turin, Italy
| | - Franca Rusconi
- Unit of Epidemiology, 'Anna Meyer' Children's University Hospital, Florence, Italy
| | - Luigi Gagliardi
- Department of Woman and Child Health, Pediatrics and Neonatology Division, Ospedale Versilia, AUSL Toscana Nord Ovest, Pisa, Italy
| | - Claudia Galassi
- CPO Piemonte, Turin, Italy.,AOU Città della Salute e della Scienza, Turin, Italy
| | - Morena Trevisan
- CPO Piemonte, Turin, Italy.,AOU Città della Salute e della Scienza, Turin, Italy
| | - Franco Merletti
- Department of Medical Sciences, University of Turin, Turin, Italy.,CPO Piemonte, Turin, Italy.,AOU Città della Salute e della Scienza, Turin, Italy
| | - Lorenzo Richiardi
- Department of Medical Sciences, University of Turin, Turin, Italy.,CPO Piemonte, Turin, Italy.,AOU Città della Salute e della Scienza, Turin, Italy
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Martini MG, Taborelli E, Schmidt U, Treasure J, Micali N. Infant feeding behaviours and attitudes to feeding amongst mothers with eating disorders: A longitudinal study. EUROPEAN EATING DISORDERS REVIEW 2018; 27:137-146. [DOI: 10.1002/erv.2626] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 06/12/2018] [Accepted: 06/26/2018] [Indexed: 11/08/2022]
Affiliation(s)
- Maria Giulia Martini
- Behavioural and Brain Sciences Unit; Institute of Child Health, University College of London; London UK
| | - Emma Taborelli
- Behavioural and Brain Sciences Unit; Institute of Child Health, University College of London; London UK
| | - Ulrike Schmidt
- Eating Disorders Research Unit, Institute of Psychiatry, Psychology and Neuroscience; King's College London; London UK
| | - Janet Treasure
- Eating Disorders Research Unit, Institute of Psychiatry, Psychology and Neuroscience; King's College London; London UK
| | - Nadia Micali
- Behavioural and Brain Sciences Unit; Institute of Child Health, University College of London; London UK
- Department of Psychiatry, Faculty of Medicine; University of Geneva; Geneva Switzerland
- Child and Adolescent Psychiatry Division, Department of Child and Adolescent Health; Geneva University Hospital; Geneva Switzerland
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Larsen PS, Strandberg-Larsen K, Olsen EM, Micali N, Nybo Andersen AM. Parental characteristics in association with disordered eating in 11- to 12-year-olds: A study within the Danish National Birth Cohort. EUROPEAN EATING DISORDERS REVIEW 2018; 26:315-328. [PMID: 29700895 DOI: 10.1002/erv.2599] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 03/15/2018] [Accepted: 03/25/2018] [Indexed: 01/12/2023]
Abstract
We examined the association between parental characteristics and disordered eating among 11- to 12-year-olds within the Danish National Birth Cohort. Frequency of fasting, purging, and binge eating was obtained by self-report from 37,592 children and combined into a measure of disordered eating (no, monthly, and weekly). Information on parental characteristics was obtained during pregnancy, from the 7-year follow-up, and by linkage to population registers. Data were analysed using multinomial logistic regression models with robust standard errors. In total, 3.1% reported weekly and 4.1% reported monthly disordered eating. Parental young age, low educational level, and overweight/obesity were associated with disordered eating. The relative risk ratios for, respectively, weekly and monthly disordered eating according to maternal eating disorder were 1.01 [0.75, 1.37] and 1.09 [0.84, 1.42]. Disordered eating is common among children and is associated with several parental characteristics. We found social inequality in disordered eating, but our data did not support an association with maternal eating disorder.
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Affiliation(s)
- Pernille Stemann Larsen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Else Marie Olsen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Healthcare Services, Research Centre for Prevention and Health, Capital Region, Denmark
| | - Nadia Micali
- UCL - Great Ormond Street Institute of Child Health, London, UK.,Department of Psychiatry, Faculty of Medicine, University of Geneva, Switzerland.,Child and Adolescent Psychiatry Division, Department de 'enfant et de l'adolescent, HUG, Geneva, Switzerland
| | - Anne-Marie Nybo Andersen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Robinson L, Aldridge V, Clark EM, Misra M, Micali N. Pharmacological treatment options for low Bone Mineral Density and secondary osteoporosis in Anorexia Nervosa: A systematic review of the literature. J Psychosom Res 2017; 98:87-97. [PMID: 28554377 PMCID: PMC7050204 DOI: 10.1016/j.jpsychores.2017.05.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 05/10/2017] [Accepted: 05/11/2017] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Although there are several evidence-based treatments available to increase Bone Mineral Density (BMD) and reduce fracture risk in aging men and women, there are still uncertainties regarding which treatments are efficacious in reducing lifetime fracture risk in women with Anorexia Nervosa (AN). METHODS Medline, PsychInfo, Embase and the Cochrane Database were searched for English Language Studies. Inclusion criteria were studies of females of any age with AN who received pharmacological treatment with the primary aim to increase BMD or reduce fracture risk. Data were extracted from each study regarding pharmacological treatment and dosage used, BMD and bone formation marker outcomes; and participant characteristics including age, Body Mass Index (BMI), duration of AN, and duration of amenorrhea. RESULTS 675 studies were reviewed, of which 19 fit the inclusion criteria and were included in the final review, investigating a total of 1119 participants; 10 of the 19 included studies were double-blind RCTs. The remaining studies consisted of prospective observational studies, a retrospective cohort study, a case-control study and five non-randomised control trials. Bisphosphonates were effective in increasing BMD in adult women with AN, while estrogen administered transdermally resulted in significant increases in BMD in mature adolescents with AN. Administration of oral contraceptives (OC) did not significantly increase BMD in randomised or controlled trials, however, lifetime OC use was associated with higher spinal BMD. CONCLUSION Future research should clarify the safety of long-term bisphosphonate use in adult women with AN, and verify that transdermal estrogen replacement increases BMD in women with AN.
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Affiliation(s)
- Lauren Robinson
- Institute of Child Health, University College London, Gower Street, London WC1E 6BT, UK; Dept. of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA.
| | - Victoria Aldridge
- Institute of Child Health, University College London, Gower Street, London WC1E 6BT, UK
| | - Emma M Clark
- Musculoskeletal Research Unit, University of Bristol, Bristol, UK
| | - Madhusmita Misra
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Nadia Micali
- Institute of Child Health, University College London, Gower Street, London WC1E 6BT, UK,Dept. of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
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