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Patterns of remission, continuation and incidence of broadly defined eating disorders during early pregnancy in the Norwegian Mother and Child Cohort Study (MoBa)

Published online by Cambridge University Press:  10 May 2007

CYNTHIA M. BULIK ,
ANN VON HOLLE ,
ROBERT HAMER ,
CECILIE KNOPH BERG ,
LEILA TORGERSEN ,
PER MAGNUS ,
CAMILLA STOLTENBERG ,
ANNA MARIA SIEGA-RIZ ,
PATRICK SULLIVAN  and
TED REICHBORN-KJENNERUD
CYNTHIA M. BULIK*
Affiliation:
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
ANN VON HOLLE
Affiliation:
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
ROBERT HAMER
Affiliation:
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
CECILIE KNOPH BERG
Affiliation:
Division of Mental Health, Norwegian Institute of Public Health, Norway
LEILA TORGERSEN
Affiliation:
Division of Mental Health, Norwegian Institute of Public Health, Norway
PER MAGNUS
Affiliation:
Epidemiology, Norwegian Institute of Public Health, Norway
CAMILLA STOLTENBERG
Affiliation:
Epidemiology, Norwegian Institute of Public Health, Norway
ANNA MARIA SIEGA-RIZ
Affiliation:
Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
PATRICK SULLIVAN
Affiliation:
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
TED REICHBORN-KJENNERUD
Affiliation:
Division of Mental Health, Norwegian Institute of Public Health, Norway Department of Psychiatry, University of Oslo, Norway
*
*Address for correspondence: Dr C. M. Bulik, Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive, CB #7160, Chapel Hill, NC 27599-7160, USA. (Email: [email protected])
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Abstract

Background

We explored the course of broadly defined eating disorders during pregnancy in the Norwegian Mother and Child Cohort Study (MoBa) at the Norwegian Institute of Public Health.

Method

A total of 41 157 pregnant women, enrolled at approximately 18 weeks' gestation, had valid data from the Norwegian Medical Birth Registry. We collected questionnaire-based diagnostic information on broadly defined anorexia nervosa (AN), and bulimia nervosa (BN), and eating disorders not otherwise specified (EDNOS). EDNOS subtypes included binge eating disorder (BED) and recurrent self-induced purging in the absence of binge eating (EDNOS-P). We explored rates of remission, continuation and incidence of BN, BED and EDNOS-P during pregnancy.

Results

Prepregnancy prevalence estimates were 0·1% for AN, 0·7% for BN, 3·5% for BED and 0·1% for EDNOS-P. During early pregnancy, estimates were 0·2% (BN), 4·8% (BED) and 0·1% (EDNOS-P). Proportions of individuals remitting during pregnancy were 78% (EDNOS-P), 40% (BN purging), 39% (BED), 34% (BN any type) and 29% (BN non-purging type). Additional individuals with BN achieved partial remission. Incident BN and EDNOS-P during pregnancy were rare. For BED, the incidence rate was 1·1 per 1000 person-weeks, equating to 711 new cases of BED during pregnancy. Incident BED was associated with indices of lower socio-economic status.

Conclusions

Pregnancy appears to be a catalyst for remission of some eating disorders but also a vulnerability window for the new onset of broadly defined BED, especially in economically disadvantaged individuals. Vigilance by health-care professionals for continuation and emergence of eating disorders in pregnancy is warranted.

Type
Original Article
Information
Psychological Medicine , Volume 37 , Issue 8 , August 2007 , pp. 1109 - 1118
Copyright
Copyright © Cambridge University Press 2007

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