1
|
Meier K, Apon LC, Van Hoeken D, Van Eeden AE, Hoek HW, Oldehinkel AJ. Impact of parenthood on eating pathology in young adults. Int J Eat Disord 2024; 57:1746-1755. [PMID: 38801161 DOI: 10.1002/eat.24225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 04/23/2024] [Accepted: 04/23/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVE Few studies investigated parenthood as a predictor of eating pathology in young adulthood. We studied the association between parenthood, in the first year after becoming a parent and beyond, and eating pathology. Furthermore, we examined whether moving in together with a partner affected this association. METHOD This study used data of four measurement waves from TRAILS (Tracking Adolescents' Individual Lives Survey), a Dutch community cohort study (N = 2229) from preadolescence into young adulthood. The Eating Disorder Diagnostic Scale (EDDS), a measure to assess eating pathology, was assessed at ages 22, 26, and 29. Risk for eating disorder was assessed at age 19. Pregnant participants were excluded. RESULTS Parenthood was not associated with an increase of eating pathology in the first year after becoming a parent and beyond. Instead, parents were more likely to report being free from eating pathology symptoms compared to childless individuals (OR 2.07, 95% CI: 1.11-3.84). Among those who reported experiencing at least one eating problem, parenthood was not associated with the number of eating problems. Moving in together with a partner did not alter the association between parenthood and eating problems and neither did this association differ between males and females. DISCUSSION Parenthood in young adulthood was associated with a decreased risk of having eating pathology. PUBLIC SIGNIFICANCE STATEMENT In this longitudinal study among young adults, parenthood was not associated with the development of eating pathology.
Collapse
Affiliation(s)
- K Meier
- Parnassia Psychiatric Institute, The Hague, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands
| | - L C Apon
- Dutch Healthcare Authority, Utrecht, The Netherlands
| | - D Van Hoeken
- Parnassia Psychiatric Institute, The Hague, The Netherlands
| | - A E Van Eeden
- Parnassia Psychiatric Institute, The Hague, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands
| | - H W Hoek
- Parnassia Psychiatric Institute, The Hague, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands
- Columbia University, Mailman School of Public Health, Department of Epidemiology, New York, New York, USA
| | - A J Oldehinkel
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands
| |
Collapse
|
2
|
Gerges S, Obeid S, Hallit S. Traversing mental health disorders during pregnancy: Lebanese women's experiences of antepartum depression and anxiety. Ir J Med Sci 2023; 192:2949-2959. [PMID: 37081286 PMCID: PMC10117264 DOI: 10.1007/s11845-023-03371-0] [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: 07/23/2022] [Accepted: 04/11/2023] [Indexed: 04/22/2023]
Abstract
INTRODUCTION Over the past few years, Lebanon-a developing country-has faced a plethora of economic and political challenges, with more than half of the general population presenting depressive and anxiety symptoms. However, when it comes to maternal mental health during pregnancy, the last examination in Lebanon dates far back to 2005. Our study's aim was to help delineate the factors associated with Lebanese women's mental health disorders during pregnancy, namely antepartum depression and anxiety. METHODS We launched a cross-sectional study among Lebanese pregnant women (age ≥ 18 years) between June and July 2021, during the COVID-19 lockdown (N = 433). RESULTS In total, 87.8% of the participants experienced depression (mild to severe), where severe depression was observed in 7.9%. In addition, 70.3% had a significant level of anxiety. Increased pregnancy-specific hassles (beta = 0.93), being Muslim compared to Christians (beta = 3.19), being afraid of an existing aggressor (beta = 8.75), urinary tract infections (beta = 2.02), and higher gestational age (beta = 0.07) were significantly associated with higher depression, whereas higher physical activity index (beta = - 0.09) and increased disordered eating attitudes during pregnancy (beta = - 0.27) were significantly associated with less depression, all accounting for 60.4% of the model's variance. Additionally, increased pregnancy-specific hassles (beta = 0.54), being Muslim compared to Christians (beta = 2.42), urinary tract infections (beta = 1.72), and having been emotionally or physically abused (beta = 1.19) were significantly associated with higher levels of anxiety and could predict 49% of the total variance. CONCLUSION Our study has suggested the existence of factors that have additive effects in potentiating the risk for depression and anxiety among Lebanese pregnant women, namely cultural beliefs, pregnancy-related distress, medical complications during pregnancy, and a history of abuse. Therefore, it would be judicious to implement screening programs targeting pregnant women at risk for antepartum depression and anxiety. In addition, high rates of prenatal depression and anxiety were detected among our sample, supporting that recognizing and treating maternal mental health disorders should be prioritized during antenatal care in Lebanon.
Collapse
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
| |
Collapse
|
3
|
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.
Collapse
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.
| |
Collapse
|
4
|
Magee KE, Qu Y, Cheng Y, Hipwell AE, Levine MD. The association between preconception loss of control over eating and depressive symptom trajectories from childhood through first pregnancy. Int J Eat Disord 2023; 56:1814-1819. [PMID: 37264988 PMCID: PMC10524878 DOI: 10.1002/eat.24004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 05/18/2023] [Accepted: 05/19/2023] [Indexed: 06/03/2023]
Abstract
OBJECTIVE Loss of control over eating (LOC) during pregnancy impacts prenatal health and often co-occurs with depressive symptoms. However, the role of depression history as a risk factor for LOC prior to pregnancy is unclear; information that is essential for effective prenatal health promotion. We examined the association between trajectories of depressive symptoms from childhood to first pregnancy and preconception LOC. METHOD Participants (N = 1031) were predominantly Black, first-time mothers enrolled in the population-based Pittsburgh Girls Study. LOC and depressive symptoms were measured annually. Pre-pregnancy height and weight, and gestational weight gain data were abstracted from medical records. RESULTS There was a significant difference in age of first conception for Black and White individuals (t = 8.73, df = 976, p < .001). Latent class analysis revealed four and three classes of depressive symptom trajectories for Black and White individuals, respectively. In the entire sample, the high-changing and moderate-decreasing classes of depressive symptoms were each associated with lifetime, in preconception year and not in preconception year, LOC (X2 = 56.7, p < .001). DISCUSSION High levels of lifetime depressive symptoms may increase vulnerability to future LOC prior to first pregnancy, suggesting potential targets for interventions to improve maternal health. PUBLIC SIGNIFICANCE Both depression history and disordered eating behaviors are known to influence prenatal health. The present study revealed associations between high levels of depressive symptoms from childhood through first pregnancy and loss of control over eating that included the year prior to conception. Results highlight potential targets for preconception interventions with relevance for future prenatal health.
Collapse
Affiliation(s)
| | - Yang Qu
- Department of Statistics, University of Pittsburgh
| | - Yu Cheng
- Department of Statistics, University of Pittsburgh
- Department of Biostatistics, University of Pittsburgh
| | - Alison E. Hipwell
- Department of Psychiatry, University of Pittsburgh
- Department of Psychology, University of Pittsburgh
| | - Michele D. Levine
- Department of Psychiatry, University of Pittsburgh
- Department of Psychology, University of Pittsburgh
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh
| |
Collapse
|
5
|
Trinh NTH, Semark BD, Munk-Olsen T, Liu X, Rø Ø, Bulik CM, Torgersen L, Lupattelli A, Petersen LV. Psychiatric visits during the postpartum year in women with eating disorders who continue or discontinue antidepressant treatment in pregnancy. Int J Eat Disord 2023; 56:582-594. [PMID: 36524675 PMCID: PMC10853670 DOI: 10.1002/eat.23877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 11/23/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To determine the association between continued antidepressant use in pregnancy and postpartum psychiatric visits for eating (ED) or mood/anxiety disorders in women with preexisting ED. METHOD Using Danish health registry data (1998-2015), we identified 3529 pregnancies in women with ED prepregnancy: (i) 564 with continued antidepressant use before and during pregnancy; (ii) 778 with discontinued antidepressants before pregnancy; (iii) 2137 unexposed. Outpatient and inpatient postpartum visits for an ED or a mood/anxiety disorder constituted the outcome measures. We estimated hazard ratios (HRs) and 95% confidence intervals (CI) using Cox regression with inverse probability of treatment weighting, and performed stratified analyses by antidepressant prescription filling in the first 3 months postpartum. RESULTS The weighted cumulative incidence for an ED visit at end of follow-up was 4.5% (continued) and 4.8% (discontinued). We found no association between continued antidepressant and postpartum ED visit, relative to discontinued (HR: 0.89, 95% CI: 0.52-1.52). The HR for postpartum mood/anxiety disorder visit was 1.27 (95% CI: 0.68-2.36) with continued antidepressants versus discontinued but decreased if more than two antidepressant prescriptions were refilled. Continued antidepressant use was associated with a 57% reduced likelihood of a postpartum ED visit versus discontinued use in pregnancies with antidepressant prescription refills in the early postpartum. CONCLUSION Among women with preexisting ED, there was no association between continued antidepressant use during pregnancy and the likelihood of postpartum psychiatric visits, relative to discontinued antidepressants before pregnancy. Continuation of treatment into the early postpartum is associated with reduced likelihood of postpartum ED visit. PUBLIC SIGNIFICANCE Based on data from the Danish registries, we identified 3529 pregnancies among women with preexisting eating disorders before pregnancy. Women with continued antidepressant treatment both before and during pregnancy did not have a lower probability of having postpartum psychiatric visits for an eating disorder or for mood/anxiety disorders (often coexisting with eating disorders), relative to those who discontinued antidepressants before pregnancy. Further continuation of antidepressant treatment into the early postpartum is associated with improved maternal postpartum outcomes. However, residual confounding by disease severity limits confidence in this conclusion.
Collapse
Affiliation(s)
- Nhung TH Trinh
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, University of Oslo, Norway
| | - Birgitte Dige Semark
- NCRR-The National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- CIRRAU - Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Trine Munk-Olsen
- NCRR-The National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- Department of Clinical Research, University of Southern Denmark, Denmark
| | - Xiaoqin Liu
- NCRR-The National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Øyvind Rø
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Norway
- Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Norway
| | - Cynthia M Bulik
- UNC Center of Excellence for Eating Disorders, Department of Psychiatry, University of North Carolina at Chapel Hill, USA
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina at Chapel Hill, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Leila Torgersen
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Angela Lupattelli
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, University of Oslo, Norway
| | | |
Collapse
|
6
|
Mah B, Cibralic S, Hanna J, Hart M, Loughland C, Cosh S. Outcomes for infants whose mothers had an eating disorder in the perinatal period: A systematic review of the evidence. Int J Eat Disord 2021; 54:2077-2094. [PMID: 34608655 DOI: 10.1002/eat.23612] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 09/11/2021] [Accepted: 09/12/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To establish any health outcomes for infants to age one, associated with their mother having a diagnosis of an active eating disorder during pregnancy or the 12-month postnatal period. METHOD A qualitative systematic literature review of numerous databases (Medline, PsycINFO, CINAHL, Scopus, Cochrane Library, MedNar, PsycExtra, National Institute for Health and Care Excellence and Open Grey) was performed examining any infant health outcomes. RESULTS This resulted in 22 included studies (17 cohort, 3 cross-sectional, 1 case controlled and 1 mixed methods study). A range of adverse infant outcomes including poor birth, growth and interactional feeding outcomes were identified. DISCUSSION Antenatal identification and treatment for women with an eating disorder during the perinatal period and their infants are vital. Optimizing pregnancy nutrition, maternal eating disorder symptoms and feeding interactions appear particularly important.
Collapse
Affiliation(s)
- Beth Mah
- Raphael Services, Blacktown, New South Wales, Australia.,School of Psychiatry, AGSM Building, UNSW, Sydney, New South Wales, Australia.,Centre for Brain and Mental Health, University of Newcastle, Waratah, New South Wales, Australia
| | - Sara Cibralic
- School of Psychiatry, AGSM Building, UNSW, Sydney, New South Wales, Australia.,The Toddler Clinic, Karitane, The Horsley Drive, Carramar, New South Wales, Australia
| | - Joanne Hanna
- School of Psychology, University of New England, Armidale, New South Wales, Australia
| | - Melissa Hart
- Centre for Brain and Mental Health, University of Newcastle, Waratah, New South Wales, Australia.,Hunter New England Mental Health, Hunter New England Local Health District, Waratah, New South Wales, Australia
| | - Carmel Loughland
- Centre for Brain and Mental Health, University of Newcastle, Waratah, New South Wales, Australia.,Hunter New England Mental Health, Hunter New England Local Health District, Waratah, New South Wales, Australia
| | - Suzanne Cosh
- School of Psychology, University of New England, Armidale, New South Wales, Australia
| |
Collapse
|
7
|
Differential Effects of Intuitive and Disordered Eating on Physical and Psychological Outcomes for Women with Young Children. Matern Child Health J 2021; 26:407-414. [PMID: 34655423 DOI: 10.1007/s10995-021-03251-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Pressure to lose weight can increase the risk of developing disordered eating behaviours, negative body image and depressive symptomatology. Eating intuitively may counteract these negative outcomes. This research examined the unique relationship between intuitive eating and disordered eating on body mass index (BMI), body image and depressive symptoms for women of young children. METHODS A survey of women with a child aged between six and 48 months, included the Intuitive Eating Scale, Eating Attitudes Test-26, Body Shape Questionnaire and Edinburgh Postnatal Depression Scale. Multivariate analysis of variance (MANOVA) was conducted as an omnibus test to estimate the effect of intuitive and disordered eating on BMI, negative body image and depressive symptoms. RESULTS Of the 419 sample (M age = 32.06), 32% were classified with disordered and 32% with intuitive eating. MANOVA and regression analysis found disordered eating positively associated with depressive symptoms, (β = 0.303) and negative body image (β = 0.318). Intuitive eating was associated with lower depressive symptoms (β = - 0.183) and negative body image (β = - 0.615). Disordered eating (β = - 0.194) and intuitive eating (β = - 0.586) both contributed to lower BMI, with the association stronger for intuitive eating. CONCLUSION The early parenting period involves a high risk for developing disordered eating behaviours. Eating patterns are modifiable factors, illustrating the potential for positive and preventive health outcomes through adopting intuitive eating behaviours. There is an opportunity for healthcare professionals to promote physical and psychological health including for women in the early parenting period.
Collapse
|
8
|
Baskin R, Meyer D, Galligan R. Psychosocial factors, mental health symptoms, and disordered eating during pregnancy. Int J Eat Disord 2020; 53:873-882. [PMID: 32199037 DOI: 10.1002/eat.23264] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 03/02/2020] [Accepted: 03/04/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The impact of disordered eating extends beyond women with a diagnosed eating disorder. Scarce research to date has investigated disordered eating in a general perinatal population, including the complex interplay between psychosocial factors, mental health symptoms, and disordered eating at numerous pregnancy periods. Specifically, maternal attitudes and relationship satisfaction are psychosocial factors that have been identified as a gap in the literature. METHOD Pregnant women completed an online questionnaire between 18 and 24 weeks gestation (T1, n = 258) and again between 30 and 32 weeks gestation (T2, n = 159). Structural equation modeling was used to test an interrelated model of psychosocial factors-attitudes to pregnancy, attitudes to motherhood, and relationship satisfaction-and disordered eating, mediated by either depressive or anxiety symptoms. Invariance testing examined whether model weights differed between primiparous and multiparous women at each time point. RESULTS While at T1 and T2, there were significant direct associations between psychosocial factors and disordered eating, only at T2 were the associations between psychosocial factors and disordered eating mediated by depressive and anxiety symptoms. Furthermore, at T2, multiparous women were at greater risk of an association between maladaptive attitudes to pregnancy and motherhood, depressive symptoms, and disordered eating. DISCUSSION The present study highlights the need to investigate the relationships between psychosocial factors and disordered eating, while accounting for the unique antenatal needs of women during different pregnancy periods and across differing parity. The mediating effect of depressive and anxiety symptoms have implications for future research and clinical care.
Collapse
Affiliation(s)
- Rachel Baskin
- Department of Psychological Sciences, Swinburne University, Hawthorn, Victoria, Australia
| | - Denny Meyer
- Centre for Mental Health, Swinburne University, Hawthorn, Victoria, Australia
| | - Roslyn Galligan
- Department of Psychological Sciences, Swinburne University, Hawthorn, Victoria, Australia
| |
Collapse
|