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Remission, continuation and incidence of eating disorders during early pregnancy: a validation study in a population-based birth cohort

Published online by Cambridge University Press:  20 November 2012

H. J. Watson ,
A. Von Holle ,
R. M. Hamer ,
C. Knoph Berg ,
L. Torgersen ,
P. Magnus ,
C. Stoltenberg ,
P. Sullivan ,
T. Reichborn-Kjennerud  and
C. M. Bulik
H. J. Watson
Affiliation:
Centre for Clinical Interventions, Department of Health in Western Australia, Northbridge, WA, Australia Eating Disorders Program, Princess Margaret Hospital for Children, Department of Health in Western Australia, Subiaco, WA, Australia School of Paediatrics and Child Health, The University of Western Australia, Nedlands, WA, Australia
A. Von Holle
Affiliation:
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
R. M. Hamer
Affiliation:
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
C. Knoph Berg
Affiliation:
Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway
L. Torgersen
Affiliation:
Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway
P. Magnus
Affiliation:
Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
C. Stoltenberg
Affiliation:
Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway
P. Sullivan
Affiliation:
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
T. Reichborn-Kjennerud
Affiliation:
Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway Department of Psychiatry, University of Oslo, Oslo, Norway
C. M. Bulik*
Affiliation:
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
*
*Address for correspondence: C. Bulik, Ph.D., Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive, CB#7160, Chapel Hill, North Carolina 27599-7160, USA. (Email: cynthia_bulik@med.unc.edu)
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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.

Keywords

Eating disordersepidemiologyincidenceNorwegian Mother and Child Cohort Studypregnancyprospective studiesremission
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 8 , August 2013 , pp. 1723 - 1734
Copyright
Copyright © Cambridge University Press 2012 

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