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Emery RL, Benno MT, Kleih T, Bell E, Mason SM, Levine MD. Childhood traumatic events and loss of control eating in pregnancy: Findings from a community sample of women with overweight and obesity. Eat Behav 2021; 42:101513. [PMID: 33966990 PMCID: PMC8380671 DOI: 10.1016/j.eatbeh.2021.101513] [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: 11/09/2020] [Revised: 04/19/2021] [Accepted: 04/26/2021] [Indexed: 11/21/2022]
Abstract
Although eating disorder symptoms generally decrease in pregnancy, loss of control eating (LOC), defined by the consumption of food accompanied by a sense of being unable to control what or how much is eaten, often persists and may develop in pregnancy. Given that LOC is associated with higher weight status and psychological distress, it is important to understand factors associated with perinatal LOC. Although childhood traumatic events have been linked to LOC in non-pregnant women, the impact of such events on LOC in pregnancy is unknown. Accordingly, the present study aimed to examine the association between a history of childhood traumatic events and LOC prior to and during pregnancy among a community sample of pregnant women with overweight or obesity. Pregnant women (N = 244) were enrolled in a longitudinal study. Women completed interviews between 12 and 20 weeks gestation to document a history of childhood traumatic events and the presence of LOC in the three months prior to and during their current pregnancy. Women were assessed for LOC monthly for the remainder of pregnancy. Results from a multinomial regression model showed that women with a history of childhood traumatic events had higher odds of engaging in LOC both prior to and during pregnancy (OR = 2.52, 95% CI [1.13, 5.64], p = 0.02) but not during pregnancy only (OR = 1.58, 95% CI [0.87, 2.89], p = 0.39). These findings indicate that women with a history of childhood traumatic events may be especially prone to LOC in the months prior to conception that continues throughout pregnancy.
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Affiliation(s)
- Rebecca L Emery
- University of Minnesota, School of Public Health, Division of Epidemiology and Community Health, Minneapolis, MN, USA.
| | - Maria Tina Benno
- University of Pittsburgh Medical Center, Department of Psychiatry, Pittsburgh, PA, USA
| | - Theresa Kleih
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Elizabeth Bell
- University of Pittsburgh Medical Center, Department of Psychiatry, Pittsburgh, PA, USA
| | - Susan M Mason
- University of Minnesota, School of Public Health, Division of Epidemiology and Community Health, Minneapolis, MN, USA
| | - Michele D Levine
- University of Pittsburgh Medical Center, Department of Psychiatry, Pittsburgh, PA, USA
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2
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Silvani J, Schmidt MI, Zajdenverg L, Galliano LM, Antunes Nunes MA. Impact of binge eating during pregnancy on gestational weight gain and postpartum weight retention among women with gestational diabetes mellitus: LINDA-Brasil. Int J Eat Disord 2020; 53:1818-1825. [PMID: 32812662 DOI: 10.1002/eat.23361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 07/18/2020] [Accepted: 07/19/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Binge eating (BE) is associated with gestational weight gain, which is a risk factor for gestational diabetes (GDM). Little is known about this association in women with GDM. To evaluate the relationship of BE in pregnancy with gestational weight gain, BE at postpartum and postpartum weight retention in women with GDM. METHOD Lifestyle INtervention for Diabetes prevention After pregnancy (LINDA-Brasil) is a multicenter cohort study with 1,958 women with GDM. BE was assessed by interview during recruitment in pregnancy and at a phone interview at ~4 months postpartum. Gestational weight gain was classified according to the 2009 Institute of Medicine (IOM) recommendations. Poisson regression with robust variance was used to estimate adjusted relative risks (RR). RESULTS Prevalence of BE was 31.6% (95% confidence interval [CI] 29.5-33.6%) during pregnancy and 30.0% (95% CI 28.0-32.1%) at postpartum. The risk of exceeding the IOM's recommendation for gestational weight gain was 45% higher (RR 1.45, 95% CI 1.29-1.63) in women who had BE during pregnancy compared to those who did not. The risk of having postpartum weight retention above the 75th percentile was 33% higher (RR 1.33, 95% CI 1.10-1.59) among those with BE compared to those without. DISCUSSION Among these women with GDM, BE was frequent and was associated with excessive gestational weight gain and weight retention at postpartum. Thus, given the vulnerability of these periods of the life cycle, tracking this eating behavior is important for the management of gestational weight gain and for the prevention of excessive postpartum retention.
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Affiliation(s)
- Juliana Silvani
- Postgraduate Program in Epidemiology, Department of Social Medicine, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Maria Inês Schmidt
- Postgraduate Program in Epidemiology, Department of Social Medicine, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Lenita Zajdenverg
- Diabetes and Nutrology Section, Internal Medicine Department, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Leony Morgana Galliano
- Postgraduate Program in Epidemiology, Department of Social Medicine, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Maria Angélica Antunes Nunes
- Postgraduate Program in Epidemiology, Department of Social Medicine, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Murray-Davis B, Grenier L, Atkinson SA, Mottola MF, Wahoush O, Thabane L, Xie F, Vickers-Manzin J, Moore C, Hutton EK. Experiences regarding nutrition and exercise among women during early postpartum: a qualitative grounded theory study. BMC Pregnancy Childbirth 2019; 19:368. [PMID: 31638920 PMCID: PMC6805669 DOI: 10.1186/s12884-019-2508-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 09/13/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Excess gestational weight gain has long- and short-term implications for women and children, and postpartum weight retention is associated with an increased risk of long-term obesity. Despite the existence of dietary and exercise guidelines, many women struggle to return to pre-pregnancy weight. Experiences of women in tackling postpartum weight loss are poorly understood. We undertook this study to explore experiences related to nutrition, exercise and weight in the postpartum in women in Ontario, Canada. METHODS This was a nested qualitative study within The Be Healthy in Pregnancy Study, a randomized controlled trial. Women randomized to the control group were invited to participate. Semi-structured focus groups were conducted at 4-6 months postpartum. Focus groups were audio recorded, transcribed verbatim, coded and analyzed thematically using a constructivist grounded theory approach. RESULTS Women experienced a complex relationship with their body image, due to unrealistic expectations related to their postpartum body. Participants identified barriers and enablers to healthy habits during pregnancy and postpartum. Gestational weight gain guidelines were regarded as unhelpful and unrealistic. A lack of guidance and information about weight management, healthy eating, and exercise in the postpartum period was highlighted. CONCLUSION Strategies for weight management that target the unique characteristics of the postpartum period have been neglected in research and in patient counselling. Postpartum women may begin preparing for their next pregnancy and support during this period could improve their health for subsequent pregnancies. TRIAL REGISTRATION NCT01689961 registered September 21, 2012.
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Affiliation(s)
- Beth Murray-Davis
- McMaster Midwifery Research Center, Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON Canada
| | - Lindsay Grenier
- McMaster Midwifery Research Center, Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON Canada
| | | | - Michelle F. Mottola
- R. Samuel McLaughlin Foundation- Exercise and Pregnancy Lab, School of Kinesiology, The University of Western Ontario, London, ON Canada
| | - Olive Wahoush
- Global Health, McMaster University, Hamilton, ON Canada
- School of Nursing, McMaster University, Hamilton, ON Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON Canada
- Biostatistics Unit, Father Sean O’Sullivan Research Centre, St Joseph’s Healthcare Hamilton, Hamilton, ON Canada
| | - Feng Xie
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON Canada
| | - Jennifer Vickers-Manzin
- Public Health Services-Healthy Families, Healthy & Safe Communities, City of Hamilton, Hamilton, ON Canada
| | - Caroline Moore
- Department of Pediatrics, McMaster University, Hamilton, ON Canada
| | - Eileen K. Hutton
- McMaster Midwifery Research Center, Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON Canada
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Consensus on the assessment of disordered eating in pregnancy: an international Delphi study. Arch Womens Ment Health 2018; 21:383-390. [PMID: 29249043 DOI: 10.1007/s00737-017-0806-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 12/12/2017] [Indexed: 01/08/2023]
Abstract
This study aimed to assess and develop consensus on the assessment of disordered eating in pregnancy. A three-round modified Delphi approach was used. Participants were international clinicians and researchers (N = 26) with extensive knowledge on and/or clinical experience with eating disorders, particularly in relation to pregnancy and/or women's health. Clear consensus among the panel, defined as 75% agreement, was reached regarding the assessment of disordered eating in pregnancy, in addition to potential assessment methods. Antenatal assessment of disordered eating was perceived to be crucial and ideally occur in a routine manner. Despite agreement that various assessment methods would be relevant in assessing disordered eating in pregnancy, psychometrically sound brief screening instruments were perceived to be most feasible for practitioners and women accessing antenatal care; however, these instruments must be pregnancy-specific and delivered in an authentic and caring manner to be beneficial.
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Fogarty S, Elmir R, Hay P, Schmied V. The experience of women with an eating disorder in the perinatal period: a meta-ethnographic study. BMC Pregnancy Childbirth 2018; 18:121. [PMID: 29720107 PMCID: PMC5932857 DOI: 10.1186/s12884-018-1762-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 04/23/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pregnancy is a time of enormous body transformation. For those with an eating disorder during pregnancy this time of transformation can be distressing and damaging to both the mother and the child. In this meta-ethnographic study, we aimed to examine the experiences of women with an Eating Disorder in the perinatal period; that is during pregnancy and two years following birth. METHOD A meta-ethnographic framework was used in this review. After a systematic online search of the literature using the keywords such as pregnancy, eating disorders, anorexia, bulimia, binge eating disorder, perinatal, postnatal and post-partum, 11 papers, involving 94 women, were included in the review. RESULTS A qualitative synthesis of the papers identified 2 key themes. The key theme that emerged during pregnancy was: navigating a 'new' eating disorder. The key that emerged in the perinatal period was return to the 'old' eating disorder. CONCLUSION Following a tumultuous pregnancy experience, many described returning to their pre-pregnancy eating behaviors and thoughts. These experiences highlight the emotional difficulty experienced having an eating disorder whilst pregnant but they also point to opportunities for intervention and a continued acceptance of body image changes. More research is needed on the experiences of targeted treatment interventions specific for pregnant and postpartum women with an eating disorder and the effectiveness of putative treatment interventions during this period.
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Affiliation(s)
- Sarah Fogarty
- School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia
| | - Rakime Elmir
- Affiliate Ingham Institute for Applied Medical Research, Centre for Applied Nursing Research (CANR), Liverpool, NSW 2170 Australia
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia
| | - Phillipa Hay
- School of Medicine and Centre for Health Research, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia
| | - Virginia Schmied
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia
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Roomruangwong C, Kanchanatawan B, Sirivichayakul S, Maes M. High incidence of body image dissatisfaction in pregnancy and the postnatal period: Associations with depression, anxiety, body mass index and weight gain during pregnancy. SEXUAL & REPRODUCTIVE HEALTHCARE 2017; 13:103-109. [PMID: 28844350 DOI: 10.1016/j.srhc.2017.08.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 07/17/2017] [Accepted: 08/05/2017] [Indexed: 10/19/2022]
Abstract
This study aimed to delineate the prevalence of body image dissatisfaction in pregnant women and parturients in relation to depression and anxiety symptoms. We assessed 126 pregnant women during the third trimester and 2-3days and 4-6weeks after delivery using the Body Image Scale (BIS). Many pregnant participants (34.1%) showed body image dissatisfaction (BIS score ≤3) which was associated with current antenatal depression, severity of depression, a lifetime history of mood disorders, trait anxiety, body mass index (BMI) and weight gain during pregnancy. The BIS score improved after delivery but was still associated with depression, lifetime history of mood disorders, age, BMI and weight gain during pregnancy. These findings suggest that about a third of pregnant women have a body image disturbance which is strongly associated with current and a life history of clinical depression and anxiety symptoms. Medical personnel should be alert to detect body image dissatisfaction in pregnant women because it may indicate an underlying mood disorder.
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Affiliation(s)
- Chutima Roomruangwong
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Buranee Kanchanatawan
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | | | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; IMPACT Research Center, Deakin University, Geelong, Australia; Department of Psychiatry, Faculty of Medicine, State University of Londrina, Londrina, Brazil. http://scholar.google.co.th/citations?user=1wzMZ7UAAAAJ&hl=th&oi=ao
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7
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Swanson V, Keely A, Denison FC. Does body image influence the relationship between body weight and breastfeeding maintenance in new mothers? Br J Health Psychol 2017; 22:557-576. [DOI: 10.1111/bjhp.12246] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 04/12/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Vivien Swanson
- Psychology Division; Faculty of Natural Sciences; University of Stirling; UK
| | | | - Fiona C. Denison
- Maternal and Fetal Health; MRC Centre for Reproductive Health; Queen's Medical Research Institute; Edinburgh UK
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8
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[Corporal image and pregnancy: A look at psychometric properties of the French translation of the Pregnancy and Weigh Gain Attitude Scale]. Encephale 2015; 42:333-9. [PMID: 26475395 DOI: 10.1016/j.encep.2015.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Accepted: 01/09/2015] [Indexed: 11/21/2022]
Abstract
BACKGROUND Body dissatisfaction among pregnant women can provoke behaviors to control weight gain and make them more vulnerable to eating disorders. Body dissatisfaction and strategies to control weight during pregnancy can have many consequences for both the mother and baby. Excessive weight gain may cause complications during childbirth and, reciprocally, a too weak weight gain could be associated with the risk of having a baby with a very low birth weight. Thus, it appears important to have a tool to detect these body image disorders in this population. As far as we know, no French-speaking tool exists, and the objective of this study was to investigate the psychometric properties of the French translation of the Pregnancy and Weight Gain Attitude Scale (PWGAS), which assesses the attitudes about weight gain during pregnancy. METHOD The sample consisted of 553 women (29.32±4.82 years) in their third trimester of pregnancy. Participants were volunteer women recruited in hospitals during obstetric consultation. All participants completed an anamnestic questionnaire, the PWGAS and a questionnaire assessing body dissatisfaction (Body Shape Questionnaire [BSQ]). The PWGAS, in its original version, includes 18 items and consists of four subscales: Positive Pregnancy Body Image; Negative Pregnancy Body Image; Indifference toward Weight Gain and Weight Gain Restrictive Behaviors. The instrument was translated and verified by expert translators. RESULTS Confirmatory factor analysis of the original version showed fit indices below recommended limits. An exploratory factor analysis on the PWGAS revealed the existence of five factors: "Fear about weight gain" (4 items); "Absence of weight gain preoccupation" (2 items); "Positive attitudes about weight gain" (4 items); "Feeling overwhelmed by weight gain" (3 items); and "Control over weight gain" (3 items). The goodness-of-fit of the five-factor model was satisfactory. The PWGAS (total and factors) is negatively correlated with the BSQ demonstrating its concurrent validity. CONCLUSION The PWGAS has satisfactory psychometric properties. This questionnaire could certainly be integrated in the monitoring of pregnant women in order to detect and guide those who show negative attitudes about the weight gain so that they can benefit from adequate care and prevent the development of eating disorders.
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Coker E, Abraham S. Body weight dissatisfaction before, during and after pregnancy: a comparison of women with and without eating disorders. Eat Weight Disord 2015; 20:71-9. [PMID: 24906550 DOI: 10.1007/s40519-014-0133-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Accepted: 05/16/2014] [Indexed: 11/29/2022] Open
Abstract
PURPOSE We examined prospectively changes in current BMI and body weight dissatisfaction in women with and without eating disorders (EDs) during and after pregnancy compared to prepregnancy. METHODS We assessed pregnant women with (ED group, N = 18) and without an ED (Control group, N = 129) using current BMI and the discrepancy between current and desired BMI (body weight dissatisfaction). This is a measure representative of overall body dissatisfaction. Women were assessed retrospectively for prepregnancy, and prospectively at weeks 12-14 (first trimester), weeks 24-26 (second trimester) and weeks 34-36 (third trimester) during pregnancy and 3, 6 and 12 months after. RESULTS Compared with prepregnancy, current BMI for the ED group increased at trimester two and three and returned to prepregnancy levels postpartum, while current BMI for the Control group increased at trimester one, two, three, and remained above their prepregnancy BMI at 3, 6 and 12 months postpartum. Compared with prepregnancy levels, body weight dissatisfaction for the ED group improved at 6 and 12 months postpartum, while body weight dissatisfaction for the Control group increased at trimester two and three, and remained greater at 3 and 6 months postpartum before returning to prepregnancy levels at 12 months postpartum. Maximum dissatisfaction occurs in trimester three for both the ED (mean 2.98, SD 2.74) and Control groups (mean 2.93, SD 3.22). CONCLUSIONS Body dissatisfaction does not improve during pregnancy in women with or without EDs. Body weight dissatisfaction remained unchanged for women with EDs during pregnancy, before a decrease at 6 and 12 months postpartum. Body weight dissatisfaction increased for women without EDs, and remained elevated until 6 months postpartum. Despite this, women with and without EDs gained significant weight during pregnancy This suggests all women require information and support regarding body image during the pregnancy and in the 12 months postpartum.
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Affiliation(s)
- Elise Coker
- Department of Women's Health, Royal North Shore Hospital, University of Sydney, Sydney, NSW, 2065, Australia,
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10
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Orloff NC, Hormes JM. Pickles and ice cream! Food cravings in pregnancy: hypotheses, preliminary evidence, and directions for future research. Front Psychol 2014; 5:1076. [PMID: 25295023 PMCID: PMC4172095 DOI: 10.3389/fpsyg.2014.01076] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 09/08/2014] [Indexed: 12/20/2022] Open
Abstract
Women in the United States experience an increase in food cravings at two specific times during their life, (1) perimenstrually and (2) prenatally. The prevalence of excess gestational weight gain (GWG) is a growing concern due to its association with adverse health outcomes in both mothers and children. To the extent that prenatal food cravings may be a determinant of energy intake in pregnancy, a better understanding of craving etiology could be crucial in addressing the issue of excessive GWG. This paper reviews the available literature to corroborate and/or dispute some of the most commonly accepted hypotheses regarding the causes of food cravings during pregnancy, including a role of (1) hormonal changes, (2) nutritional deficits, (3) pharmacologically active ingredients in the desired foods, and (4) cultural and psychosocial factors. An existing model of perimenstrual chocolate craving etiology serves to structure the discussion of these hypotheses. The main hypotheses discussed receive little support, with the notable exception of a postulated role of cultural and psychosocial factors. The presence of cravings during pregnancy is a common phenomenon across different cultures, but the types of foods desired and the adverse impact of cravings on health may be culture-specific. Various psychosocial factors appear to correlate with excess GWG, including the presence of restrained eating. Findings strongly suggest that more research be conducted in this area. We propose that future investigations fall into one of the four following categories: (1) validation of food craving and eating-related measures specifically in pregnant populations, (2) use of ecological momentary assessment to obtain real time data on cravings during pregnancy, (3) implementation of longitudinal studies to address causality between eating disorder symptoms, food cravings, and GWG, and (4) development of interventions to ensure proper prenatal nutrition and prevent excess GWG.
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Affiliation(s)
- Natalia C. Orloff
- Health Behaviors Laboratory, Department of Psychology, University at Albany – State University of New YorkAlbany, NY, USA
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11
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Changes in satisfaction with body in pregnant women participating in physical exercise classes and childbirth classes. HEALTH PSYCHOLOGY REPORT 2014. [DOI: 10.5114/hpr.2014.44424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
<b>Background</b><br />
During pregnancy, a woman’s body undergoes major transformation contrary to the present ideal image of a slim body shape. Satisfaction with the body is important for a pregnant woman because it is one of the factors that determine her physical and mental well-being. The aim of this study was to compare the changes in the satisfaction with the body in women who regularly participated in physical exercise classes (experimental group) and in women who attended traditional childbirth classes (control group).<br />
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<b>Participants and procedure</b><br />
The research included 74 women aged 22-37 years in the second and third trimesters of their first pregnancy. The experimental group consisted of 39 pregnant women who participated in physical exercise classes from the Active Nine Months program for pregnant women. The control group consisted of 36 pregnant women who participated in typical childbirth classes twice a week. The Body Shape Test for Pregnant Women and the modified version of the Body Satisfaction Scale were used.<br />
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<b>Results</b><br />
After two months, women in both groups perceived their body shape as significantly bigger; the ideal figure became plumper, and the disparity between the actual and the ideal figure increased. Dissatisfaction with torso, motor skills, and appearance did not change in the experimental group; a significant increase of dissatisfaction with appearance and motor skills was observed in the control group.<br />
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<b>Conclusions</b><br />
Regular physical exercise helps pregnant women to maintain positive attitudes towards their body.
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Gilbert JS, Cox LA, Mitchell G, Nijland MJ. Nutrient-restricted fetus and the cardio–renal connection in hypertensive offspring. Expert Rev Cardiovasc Ther 2014; 4:227-37. [PMID: 16509818 DOI: 10.1586/14779072.4.2.227] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
A suboptimal intrauterine environment has a number of deleterious effects on fetal development and postpartum health outcomes. Epidemiological studies on several human populations have linked socioeconomic status and low birth weight to an increased incidence of diseases such as hypertension, diabetes, obesity and cardiovascular disease. A growing number of experimental studies in a variety of animal models demonstrate that maternal stressors, such as nutrition and reduced uterine perfusion, affect the intrauterine milieu and result in increased blood pressure in offspring. Several mechanisms appear to contribute to hypertension, including vascular dysfunction and increased peripheral resistance, altered cardio-renal structure and alterations in cardio-renal function. Although many studies have characterized models of developmentally generated hypertension, few have begun to seek therapeutic modalities to ameliorate its incidence. This review discusses recent work that refines hypotheses linking a suboptimal intrauterine environment to cardiovascular and renal phenotypes that have increased susceptibility to cardiovascular disease and hypertension.
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Affiliation(s)
- Jeffrey S Gilbert
- Department of Obstetrics and Gynecology, Center for Pregnancy and Newborn Research, University of Texas Health Science Center, San Antonio, TX 78229, USA.
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Coker EL, Mitchell-Wong LA, Abraham SF. Is pregnancy a trigger for recovery from an eating disorder? Acta Obstet Gynecol Scand 2013; 92:1407-13. [DOI: 10.1111/aogs.12256] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Accepted: 09/01/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Elise L. Coker
- Department of Obstetrics and Gynecology; University of Sydney; Royal North Shore Hospital; St Leonards New South Wales Australia
- Northside Clinic; Greenwich New South Wales Australia
- Westmead Hospital; Westmead New South Wales Australia
| | - Lisa A. Mitchell-Wong
- Department of Obstetrics and Gynecology; University of Sydney; Royal North Shore Hospital; St Leonards New South Wales Australia
| | - Suzanne F. Abraham
- Department of Obstetrics and Gynecology; University of Sydney; Royal North Shore Hospital; St Leonards New South Wales Australia
- Northside Clinic; Greenwich New South Wales Australia
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14
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Watson HJ, Von Holle A, Hamer RM, Berg CK, Torgersen L, Magnus P, Stoltenberg C, Sullivan P, Reichborn-Kjennerud T, Bulik CM. Remission, continuation and incidence of eating disorders during early pregnancy: a validation study in a population-based birth cohort. Psychol Med 2013; 43:1723-1734. [PMID: 23164164 PMCID: PMC4206832 DOI: 10.1017/s0033291712002516] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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.
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Affiliation(s)
- Hunna J. Watson
- Centre for Clinical Interventions, Department of Health in Western Australia, Australia
- Eating Disorders Program, Princess Margaret Hospital for Children, Department of Health in Western Australia, Australia
- School of Paediatrics and Child Health, The University of Western Australia, Australia
| | - Ann Von Holle
- Department of Psychiatry, University of North Carolina at Chapel Hill, USA
| | - Robert M. Hamer
- Department of Psychiatry, University of North Carolina at Chapel Hill, USA
| | | | - Leila Torgersen
- Division of Mental Health, Norwegian Institute of Public Health, Norway
| | - Per Magnus
- Division of Epidemiology, Norwegian Institute of Public Health, Norway
| | - Camilla Stoltenberg
- Division of Epidemiology, Norwegian Institute of Public Health, Norway
- Department of Public Health and Primary Health Care, University of Bergen, Norway
| | - Patrick Sullivan
- Department of Psychiatry, University of North Carolina at Chapel Hill, USA
- Department of Genetics, University of North Carolina at Chapel Hill, USA
| | - Ted Reichborn-Kjennerud
- Division of Mental Health, Norwegian Institute of Public Health, Norway
- Department of Psychiatry, University of Oslo, Norway
| | - Cynthia M. Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, USA
- Department of Nutrition, University of North Carolina at Chapel Hill, USA
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Hubin-Gayte M, Squires C. Étude de l’impact de la grossesse sur les comportements alimentaires à travers l’utilisation du questionnaire SCOFF. EVOLUTION PSYCHIATRIQUE 2012. [DOI: 10.1016/j.evopsy.2012.01.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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16
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Cwikel JG. Strategies for Resisting Eating Disorders Over the Life Course—A Mother-Daughter Case Analysis. WOMEN & THERAPY 2011. [DOI: 10.1080/02703149.2011.591665] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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17
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Nunes MA, Ferri CP, Manzolli P, Soares RM, Drehmer M, Buss C, Giacomello A, Hoffmann JF, Ozcariz S, Melere C, Manenti CN, Camey S, Duncan BB, Schmidt MI. Nutrition, mental health and violence: from pregnancy to postpartum Cohort of women attending primary care units in Southern Brazil--ECCAGE study. BMC Psychiatry 2010; 10:66. [PMID: 20807429 PMCID: PMC2939583 DOI: 10.1186/1471-244x-10-66] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2009] [Accepted: 08/31/2010] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Woman's nutritional status, before and during pregnancy, is a strong determinant of health outcomes in the mother and newborn. Gestational weight gain and postpartum weight retention increases risk of overweight or obesity in the future and they depend on the pregestational nutritional status and on food consumption and eating behavior during pregnancy. Eating behavior during pregnancy may be the cause or consequence of mood changes during pregnancy, especially depression, which increases likelihood of postpartum depression. In Brazil, a study carried out in the immediate postpartum period found that one in three women experienced some type of violence during pregnancy. Violence and depression are strongly associated and both exposures during pregnancy are associated with increased maternal stress and subsequent harm to the infant. The main objectives of this study are: to identify food intake and eating behaviors patterns; to estimate the prevalence of common mental disorders and the experience of violence during and after pregnancy; and to estimate the association between these exposures and infant's health and development. METHODS/DESIGN This is a cohort study of 780 pregnant women receiving care in 18 primary care units in two cities in Southern Brazil. Pregnant women were first evaluated between the 16th and 36th week of pregnancy at a prenatal visit. Follow-up included immediate postpartum assessment and around the fifth month postpartum. Information was obtained on sociodemographic characteristics, living circumstances, food intake, eating behaviors, mental health and exposure to violence, and on infant's development and anthropometrics measurements. DISCUSSION This project will bring relevant information for a better understanding of the relationship between exposures during pregnancy and how they might affect child development, which can be useful for a better planning of health actions aiming to enhance available resources in primary health care.
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Affiliation(s)
- Maria A Nunes
- Graduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, Porto Alegre/RS, Brazil.
| | - Cleusa P Ferri
- Section of Epidemiology, Institute of Psychiatry, HSPR, King's College, 16 De Crespigny Park London SE5 8AF, UK
| | - Patricia Manzolli
- Graduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar - 90035-003 - Porto Alegre/RS, Brazil
| | - Rafael M Soares
- Graduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar - 90035-003 - Porto Alegre/RS, Brazil
| | - Michele Drehmer
- Graduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar - 90035-003 - Porto Alegre/RS, Brazil
| | - Caroline Buss
- Graduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar - 90035-003 - Porto Alegre/RS, Brazil
| | - Andressa Giacomello
- Graduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar - 90035-003 - Porto Alegre/RS, Brazil
| | - Juliana F Hoffmann
- Graduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar - 90035-003 - Porto Alegre/RS, Brazil
| | - Silvia Ozcariz
- Graduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar - 90035-003 - Porto Alegre/RS, Brazil
| | - Cristiane Melere
- Graduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar - 90035-003 - Porto Alegre/RS, Brazil
| | - Carlo N Manenti
- Graduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar - 90035-003 - Porto Alegre/RS, Brazil
| | - Suzi Camey
- Graduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar - 90035-003 - Porto Alegre/RS, Brazil,Statistics Department, Universidade Federal do Rio Grande do Sul, Av. Bento Gonçalves, 9500 - Prédio 43-111 - Agronomia, 91509-900 Porto Alegre/RS, Brazil
| | - Bruce B Duncan
- Graduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar - 90035-003 - Porto Alegre/RS, Brazil
| | - Maria I Schmidt
- Graduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400 - 2° andar - 90035-003 - Porto Alegre/RS, Brazil
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Swann RA, Holle AV, Torgersen L, Gendall K, Reichborn-Kjennerud T, Bulik CM. Attitudes toward weight gain during pregnancy: results from the Norwegian mother and child cohort study (MoBa). Int J Eat Disord 2009; 42:394-401. [PMID: 19115369 PMCID: PMC2696571 DOI: 10.1002/eat.20632] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To explore attitudes toward weight gain during pregnancy in women with and without eating disorders and across eating disorder subtypes, and to examine associations among weight-gain attitudes and actual gestational weight gain, infant birth weight, and infant size-for-gestational-age. METHOD Pregnant women (35,929) enrolled in the prospective population-based Norwegian mother and child cohort study (MoBa) provided information at approximately week 18 of gestation regarding eating disorders and weight gain attitudes. We explored these variables in women with anorexia nervosa, bulimia nervosa, eating disorder not otherwise specified, purging type, and binge eating disorder (BED). RESULTS The presence of an eating disorderly was associated with greater worry over gestational weight gain. In women without eating disorders, greater worry was associated with higher gestational weight gain, higher infant weights, greater likelihood of a large-for-gestational-age infant, and reduced likelihood of a small-for-gestational-age infant. Women with BED who reported greater worry also experienced higher weight gains during pregnancy. DISCUSSION Women with eating disorders tend to experience weight-gain-related worry during pregnancy. Early worry about gestational weight-gain may be a harbinger of high gestational gain.
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Affiliation(s)
- Rebecca A. Swann
- Department of Maternal and Child Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ann Von Holle
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Leila Torgersen
- Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Kelly Gendall
- Department of Internal Medicine and Women's Health, Virginia Commonwealth University Medical Center, Richmond, VA, USA
| | - Ted Reichborn-Kjennerud
- Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway,Department of Psychiatry, University of Oslo, Norway,Department of Epidemiology, Columbia University, New York, NY, USA
| | - Cynthia M Bulik
- 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
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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. Inappropriate eating behaviors during pregnancy: prevalence and associated factors among pregnant women attending primary care in southern Brazil. Int J Eat Disord 2009; 42:387-93. [PMID: 19115363 DOI: 10.1002/eat.20643] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To examine the prevalence of inappropriate eating behaviors and associated factors among pregnant women in primary care. METHOD The Eating Disorder Examination Questionnaire was used to assess eating disorders and the Primary Care Evaluation of Mental Disorders was used to examine anxiety and depressive symptoms. Body mass index (BMI) and pregestational weight were also assessed. RESULTS Prevalence of binge eating during pregnancy was 17.3% [95% confidence interval (CI) 14.5-20.0], followed by excessive shape (5.6%; 95% CI 4-8) and weight concerns (5.5%; 95% CI 4-8). Binge eating during pregnancy was significantly associated with binge eating before pregnancy [prevalence ratio (PR) = 3.1; 95% CI 2.2-4.3], current anxiety symptoms (PR = 1.8; 95% CI 1.3-2.4), and prepregnancy BMI < 19.8 kg/m(2) (PR = 1.6; 95% CI 1.1-2.5). The prevalence of eating disorders was 0.6% (95% CI 0.01-1.11). DISCUSSION Eating disorder symptoms should be routinely assessed and treated during prenatal care, along with other comorbid psychiatric symptoms such as anxiety.
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Affiliation(s)
- Rafael Marques Soares
- Post Graduate Program in Epidemiology, Federal University of Rio Grande do Sul (UFRGS), Brazil
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Dunker KLL, Alvarenga MDS, Alves VPDO. Transtornos alimentares e gestação: uma revisão. JORNAL BRASILEIRO DE PSIQUIATRIA 2009. [DOI: 10.1590/s0047-20852009000100010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Estudar o impacto dos transtornos alimentares nas funções reprodutivas, problemas na gestação e puerpério, e dificuldades com a alimentação dos filhos. MÉTODOS: Realizou-se revisão da literatura nos últimos 28 anos nos bancos de dados MedLine e Lilacs. Combinaram-se os descritores anorexia nervosa, bulimia nervosa, transtornos alimentares e gestação. RESULTADOS: Os estudos de revisão, estudos de caso e pesquisas realizadas com gestantes apontam uma associação entre TA e uma variedade de complicações na gestação, no parto, para o feto, com aumentado risco de morbidade perinatal, além de complicações na alimentação futura da criança. CONCLUSÕES: Observa-se uma maior necessidade de acompanhamento especializado, principalmente no pré-natal, em relação aos hábitos alimentares e preocupação com peso e forma corporais - especialmente nas mulheres que apresentam ganho ponderal inadequado, hiperêmese gravídica, picacismo, entre outros.
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Downs DS, DiNallo JM, Kirner TL. Determinants of pregnancy and postpartum depression: prospective influences of depressive symptoms, body image satisfaction, and exercise behavior. Ann Behav Med 2008; 36:54-63. [PMID: 18773252 DOI: 10.1007/s12160-008-9044-9] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2007] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Limited research has prospectively examined women's exercise and psychological health behaviors before, during, and after pregnancy. PURPOSE The purpose of this study was to examine the associations between and the extent to which depressive symptoms (DS), body image satisfaction (BIS), and exercise behavior (EB) prospectively explained trimester-specific and postpartum depression. METHODS Participants (N = 230 pregnant women) completed self-reported measures midway through their first, second, and third trimesters and at 6-weeks postpartum from 2005 to 2007. Women were also classified based on current activity guidelines as active and somewhat active to examine the moderating influence of pre-pregnancy EB on the contributions of the study variables for explaining DS. RESULTS We found that : (a) DS, BIS, and EB were associated across the three pregnancy time points and postpartum, (b) DS and BIS were main determinants of later depression in pregnancy and postpartum, and (c) the moderating influence of pre-pregnancy EB was evident in early pregnancy. CONCLUSIONS These preliminary findings suggest that DS and BIS are important psychological factors for intervention to improve women's pregnancy and postpartum psychological health and that EB in the pre-pregnancy period may offer women protective effects against DS in early pregnancy.
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Affiliation(s)
- Danielle Symons Downs
- Department of Kinesiology, The Pennsylvania State University, 268Q Recreation Building, University Park, PA 16802-5701, USA.
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Rocco PL, Orbitello B, Perini L, Pera V, Ciano RP, Balestrieri M. Effects of pregnancy on eating attitudes and disorders: a prospective study. J Psychosom Res 2005; 59:175-9. [PMID: 16198191 DOI: 10.1016/j.jpsychores.2005.03.002] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2004] [Revised: 03/23/2005] [Accepted: 03/23/2005] [Indexed: 11/24/2022]
Abstract
The aim of this prospective study was to investigate the effects of pregnancy on eating disorders (ED), dietary habits and body image perception. One hundred and fifty pregnant women were interviewed between the period January 2001 and May 2003. Ninety-seven women completed the study and were divided in three subgroups: pregnant women with a positive history of dieting (n=37), pregnant women with a positive history of dieting with a complete diagnosis of a current ED (n=11) and pregnant women with a negative history either of dieting or ED (control group; n=49). Age, education and parity were equally distributed in all three groups. To verify if pregnancy exerts a specific protective effect, a battery of psychometric tests was administered to women at 12 degrees (T0), 22 degrees (T1), and 34 degrees pregnancy weeks (T2), and 2 days (T3) and 4 months (T4) after delivery, respectively. The study showed a quadratic trend for ED, subthreshold ED and body satisfaction, with a general improvement in the middle of pregnancy and a return to previous levels after delivery. Some interesting significant differences came out among the groups.
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Affiliation(s)
- Pier Luigi Rocco
- Clinica Psichiatrico, DPMSC, Policlinico Universitario, University of Udine, via Colugna no. 50, Udine 33100, Italy.
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Johnson S, Burrows A, Williamson I. 'Does my bump look big in this?' The meaning of bodily changes for first-time mothers-to-be. J Health Psychol 2004; 9:361-74. [PMID: 15117536 DOI: 10.1177/1359105304042346] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Research on the impact of bodily changes during the transition to motherhood is contradictory. The aim of the study reported here was to provide more useful insights by employing an inductive qualitative approach. Interviews with six women in the latter stages of pregnancy were analysed drawing upon aspects of interpretative phenomenological analysis and Foucauldian discourse analysis. These analyses suggest generally negative consequence, and discursive constructions that have a greater potential to be limiting than empowering. The impact of gender ideologies on women's ways of being while pregnant is highlighted, as is the importance of developing alternative representations of the female, and the pregnant body, which do not pathologize women.
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Affiliation(s)
- Sally Johnson
- Division of Psychology, University College Northampton, UK.
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25
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Abstract
Intrauterine growth restriction (IUGR) is associated with maternal prepregnancy body mass index (BMI), body weight gain during pregnancy and smoking, eating and weight-losing behaviors. The aim of this pilot study was to examine the practices of obstetricians to determine whether more can be done to prevent IUGR and 'do no harm' to the body image of women during pregnancy. Obstetricians (n = 67) who reported delivering an average of 125 babies in the previous year completed a questionnaire that enquired about their antenatal practice of maternal weighing, history taking and referral of pregnant women. No doctor calculated the prepregnancy BMI. Women (90%) were weighed during some or all antenatal visits, usually by the nurse-receptionist, but one-third of the obstetricians did not refer to these body weight records. Most obstetricians asked women about their cigarette smoking and alcohol intake before pregnancy, and during pregnancy discussed supplements and nausea and vomiting. Fewer than 50% of doctors asked about depression, body weight control and disordered eating. One-third of doctors were not aware of having seen a woman with an eating disorder in the previous year. Obstetricians who asked about eating disorders were more likely to ask about depression, and obstetricians in private practice were significantly less likely to ask women about a history of depression and to refer women to a psychologist or psychiatrist Obstetricians could improve antenatal care by asking about body weight and calculating prepregnancy BMI, and investigating weight-losing behavior and psychological or psychiatric problems such as eating disorders.
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Affiliation(s)
- S Abraham
- Department of Obstetrics and Gynaecology, University of Sydney, NSW, Australia
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26
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Abraham S, Taylor A, Conti J. Postnatal depression, eating, exercise, and vomiting before and during pregnancy. Int J Eat Disord 2001; 29:482-7. [PMID: 11285587 DOI: 10.1002/eat.1046] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To examine the postnatal distress and the eating, exercise, and weight losing behavior of women before and during pregnancy. METHOD The subjects were healthy women who had given birth to a singleton healthy baby in the week before the study. They were drawn from two consecutive series of mothers of babies whose birth weights were either < or =2,500 g or >2,500 g. A total of 181 women were interviewed using a standardized interview modified for pregnancy and related behaviors. They also completed the Edinburgh Postnatal Distress Questionnaire. RESULTS Regression analysis produced a final model containing variables that made a unique contribution to predicting the level of distress of women in the week following childbirth. The model accounted for 25% of the variance and included four variables that were associated with greater distress: fear of weight gain before and during pregnancy, being distracted by thoughts of food during pregnancy, being afraid of gaining more weight than the pregnancy would explain, and vomiting more frequently during the first 3-4 months of pregnancy. A fifth variable accounted for less distress, that is, participating in low-intensity exercise for reasons of shape and weight during months 3-4 of pregnancy. Other variables associated with distress only in the preliminary analysis were maternal age, binge eating, and vomiting before pregnancy. The most distressed mothers were suffering from an eating disorder at the time of pregnancy. The binge and/or purge type of eating disorder was associated with more distress than a food restriction type. DISCUSSION Postnatal distress is associated with body weight and shape concerns, with disordered eating before and during pregnancy, and with vomiting during pregnancy. The protective role of low-intensity exercise during early pregnancy needs to be explored. Women with eating disorders should be considered at risk for postnatal problems.
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Affiliation(s)
- S Abraham
- Department of Obstetrics and Gynaecology, University of Sydney, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
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27
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Abstract
When women smokers become pregnant, they are asked to control weight gain and at the same time to relinquish an addictive drug with weight suppressing effects. For women with serious body image concerns or a history of unhealthful eating patterns, smoking cessation may be particularly problematic. To investigate the relationship of weight concerns with smoking and weight gain during pregnancy and postpartum weight loss strategies, we conducted a retrospective study of women who had given birth to their first child within the past 10 years and were smokers when they became pregnant. We observed that women smokers with high weight and body image concerns (HC) gained significantly more weight during pregnancy-in amounts that far exceeded maximum recommended weight gain-than did women with low concerns (LC). HC were more likely to adopt smoking as a weight-control strategy and to be receptive to multiple weight-control strategies. Although they lost significantly more weight in the first month postpartum than did LC, they had also gained significantly more during pregnancy; the net result was that weight loss as a percentage of weight gained did not differ significantly between groups. HC were significantly less likely to experience food cravings in the first trimester and marginally less likely to vomit than LC. We conclude that early identification of high-risk women, coordination of prenatal care with smoking cessation counseling, and development of effective relapse prevention strategies that specifically address weight issues both during and after pregnancy will be needed if efforts to reduce smoking during pregnancy and postpartum are to be optimized.
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Affiliation(s)
- C S Pomerleau
- Nicotine Research Laboratory, University of Michigan Department of Psychiatry, Ann Arbor 48108, USA.
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28
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Strychar IM, Chabot C, Champagne F, Ghadirian P, Leduc L, Lemonnier MC, Raynauld P. Psychosocial and lifestyle factors associated with insufficient and excessive maternal weight gain during pregnancy. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION 2000; 100:353-6. [PMID: 10719411 DOI: 10.1016/s0002-8223(00)00107-3] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- I M Strychar
- Research Center of the Centre Hospitalier de l'Université de Montreal (CHUM), Notre-Dame Hospital, Quebec, Canada
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29
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Mollart L. A weight off my mind: the abandonment of routine antenatal weighing a change of practice research. AUSTRALIAN COLLEGE OF MIDWIVES INCORPORATED JOURNAL 1999; 12:26-31. [PMID: 10754819 DOI: 10.1016/s1031-170x(99)80009-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The 50 year old tradition of routinely weighing pregnant women, which has been identified as an obsolete practice, is still practiced by many. The antenatal clinic and community midwives, and medical staff from the Division of Obstetrics (Central Coast Area Health Service) as well as pregnant women attending the clinics have been surveyed to identify the impact on implementing evidence based practice (ceasing routine antenatal weighing). Using both quantitative and qualitative methods to provide a rich and detailed picture, the outcomes showed that the importance of weighing decreased for most of pregnant women. Midwives were surprised at the women's' acceptance to the change; and both health professional groups did not feel a loss of overall care. This research suggests that organised and planned change can achieve acceptance of evidence based practice.
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Affiliation(s)
- L Mollart
- Central Coast Area Health Service, Copacabana NSW
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30
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Abstract
The association between clinical eating disorders, maternal body weight, shape, and eating concerns, and the birth of low-birth-weight infants (LBW; less than 2500 g) was investigated using a retrospective case-control study. Eighty-eight women delivering LBW infants were interviewed and then divided into two groups--those delivering term, small-for-gestational-age infants (SGA; 37 or more completed weeks, n = 34) and those delivering premature infants (less than 37 completed weeks, n = 54). There were 86 reference women (CTRL) matched for age, parity, and health insurance status, who delivered babies with birth weights greater than 2500 g. In the week postpartum, women delivering term SGA, premature (PREM), and CTRL infants were interviewed using a semistructured interview. One section of this interview included a modified version of the Eating Disorder Examination (EDE), which retrospectively generated, over the previous 12 months, diagnosis of an eating disorder and maternal "normative" weight and shape concerns. In the 3 months before pregnancy, 32% of SGA women, 9% PREM women, and 5% of reference women were diagnosed as having a clinical eating disorder. Women with a past history of an eating disorder had no greater risk of delivering a low-birth-weight infant. Women delivering SGA infants, reported elevated eating disorder psychopathology postdelivery (Eating Disorders Inventory, EDI) and more disturbances in eating behavior before and during pregnancy. Unique predictors for delivery of a LBW term SGA infant were: low maternal prepregnancy body weight, smoking, low maternal weekly weight gain, and elevated EDI (Bulimia subscale). Unique predictors for delivery of a LBW premature infant were: lower maternal occupational status, vomiting in pregnancy, and lower dietary restraint. Women with disordered eating were shown to be at greater risk of delivering term SGA infants. Predictors of term growth retardation are partly determined by maternal behavior.
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Affiliation(s)
- J Conti
- Department of Nutrition and Dietetics, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
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31
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Abstract
The reproductive and sexual histories of women who had recovered or were recovering from bulimia nervosa were examined. Of 48 consecutive female patients, 43 were studied 10-15 years after first presenting for treatment. At follow-up, 74% were considered recovered and 26% still had an eating disorder. Only 2 women fulfilled the criteria for bulimia nervosa. A history of amenorrhea was common (81% of women), 63% of women being without their menstrual periods for more than 12 months. Menstruation was present in women at a body mass index of 19 or more who were no longer using the weight loss practices of self-induced vomiting, laxative abuse, and starvation. Bulimia nervosa women are more likely to be investigated for infertility when their eating disorder is active. Bulimia sufferers are sexually active, but have times of withdrawing from their partners and ceasing sexual behavior. They associate their sexual feeling with body weight, pregnancy, breastfeeding, and status of their relationships. Marital breakdown is also more common but only if the eating disorder was active at the time of marriage. Forty-five percent left their relationship had a negative effect on their eating disorder. Short-term episodes of bulimic-free behavior are associated with pregnancy and breastfeeding in some pregnancies. Termination of pregnancy occurs more often. The prevalence of miscarriage, hyperemesis gravidarum, and postnatal depression was greater among women who had not recovered from their eating disorder at the time of their pregnancy. Recovery from eating disorder behavior before attempting conception reduces the prevalence of the gynecologic, obstetric, and psychiatric problems associated with eating disorder behavior.
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Affiliation(s)
- S Abraham
- Department of Obstetrics and Gynaecology, University of Sydney, New South Wales, Australia
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