The Effects of Feeding and Eating Disorders on Fetal and Maternal Health During Pregnancy

Year 2025, Issue: 26, 738 - 750, 31.08.2025

Sümeyye Begüm Atalan , Aylin Açıkgöz Pınar

https://doi.org/10.38079/igusabder.1339464

Abstract

Pregnancy is a unique metabolic state characterized by physiological, psychological, and various changes in maternal metabolism. Eating disorders are common among women and pose a risk for women of reproductive age, including those during pregnancy. Eating disorders during pregnancy play a role in reproductive health, adverse birth outcomes, fetal growth and development retardation, and the intergenerational transmission of eating disorders. Pre-pregnancy nutritional counseling is crucial to optimize maternal health and maintain pre-pregnancy body mass index within the optimal range. Special attention should be given to women with anorexia nervosa, ensuring they achieve an optimal body mass index range before conceiving. Weight gain within the limits set by the Institute of Medicine should be achieved during pregnancy. Considering findings that eating disorder symptoms tend to decrease during pregnancy but may re-emerge in the postpartum period, women with a history of eating disorders require follow-up in the postpartum phase as well. Furthermore, given the long-term benefits of breastfeeding, mothers should be encouraged to breastfeed by highlighting the protective properties and importance of breast milk.

Keywords

Pregnancy , anorexia nervosa , bulimia nervosa , eating disorders

Gebelik Döneminde Beslenme ve Yeme Bozukluklarının Fetal ve Maternal Sağlık Üzerine Etkileri

Abstract

Gebelik, maternal metabolizmada meydana gelen fizyolojik, psikolojik ve çeşitli değişiklikler ile karakterize benzersiz bir metabolik durumdur. Kadınlar arasında yeme bozuklukları yaygın olup, doğurganlık çağındaki ve gebelik dönemindeki kadınlar açısından risk teşkil eder. Gebelik döneminde yeme bozuklukları üreme sağlığı, bir dizi olumsuz doğum sonuçları, fetal büyüme ve gelişmede gerilik ve yeme bozukluklarının nesiller arası geçişinde rol alır. Gebelik öncesi beslenme danışmanlığı, maternal sağlığı optimize etmek ve gebelik öncesi beden kütle indeksini optimal aralıkta tutmak için önemlidir. Özellikle anoreksiya nervozalı kadınların optimal beden kitle indeksi aralığına ulaşmadan gebe kalmaması konusunda dikkatli olunmalıdır. Gebelik döneminde Tıp Enstitüsü tarafından belirlenen sınırlar dahilinde ağırlık kazanımı sağlanmalıdır. Yeme bozukluklarının semptomlarının gebelikte azaldığı, ancak postpartum dönemde tekrar ortaya çıkabileceği bulguları göz önüne alındığında, yeme bozukluğu öyküsü olan kadınların gebelik sonrası dönemde de izlemi gerekmektedir. Ayrıca anne sütünün uzun vadeli etkileri göz önüne alınarak anne sütünün önemi ve koruyucu özellikleri anlatılarak emzirme için anneler teşvik edilmelidir.

Keywords

Gebelik , anoreksiya nervoza , bulimia nervoza , yeme bozuklukları

References

• 1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013.
• 2. GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1789-1858.
• 3. Mathieu J. What is pregorexia? J Am Diet Assoc. 2009;109(6):976-979.
• 4. Tuncer E, Gumus AB, Keser A. The importance of pregorexia awareness. Clin Exp Health Sci. 2020;10(3):186-190. doi:10.33808/clinexphealthsci.673306.
• 5. Bye A, Nath S, Ryan EG, et al. Prevalence and clinical characterisation of pregnant women with eating disorders. Eur Eat Disord Rev. 2020;28(2):141-155. doi: 10.1002/erv.2719.
• 6. Galmiche M, Dechelotte P, Lambert G, Tavolacci MP. Prevalence of eating disorders over the 2000-2018 period: A systematic literature review. Am J Clin Nutr. 2019;109(5):1402-1413. doi: 10.1093/ajcn/nqy342.
• 7. Easter A, Bye A, Taborelli E, et al. Recognising the symptoms: How common are eating disorders in pregnancy? Eur Eat Disord Rev. 2013;21(4):340-4. doi: 10.1002/erv.2229.
• 8. Jones C, Pearce B, Barrera I, Mummert A. Fetal programming and eating disorder risk. J Theor Biol. 2017;428:26-33. doi: 10.1016/j.jtbi.2017.05.028.
• 9. Watson HJ, O'Brien A, Sadeh-Sharvit S. Children of parents with eating disorders. Curr Psychiatry Rep. 2018;20(11):101. doi: 10.1007/s11920-018-0970-3.
• 10. Kass A, Dorsam AF, Weiss M, Zipfel S, Giel KE. The impact of maternal eating disorders on breastfeeding practices: A systematic review. Arch Womens Ment Health. 2021;24(5):693-708. doi: 10.1007/s00737-021-01103-w.
• 11. O'Brien KM, Whelan DR, Sandler DP, Hall JE, Weinberg CR. Predictors and long-term health outcomes of eating disorders. PLoS One. 2017;12(7):e0181104.
• 12. Marzola E, Cavallo F, Panero M, Porliod A, Amodeo L, Abbate-Daga G. The role of prenatal and perinatal factors in eating disorders: A systematic review. Arch Womens Ment Health. 2021;24(2):185-204. doi: 10.1007/s00737-020-01057-5.
• 13. Tay CT, Teede HJ, Hill B, Loxton D, Joham AE. Increased prevalence of eating disorders, low self-esteem, and psychological distress in women with polycystic ovary syndrome: A community-based cohort study. Fertil Steril. 2019;112(2):353-361.
• 14. Bannatyne AJ, Hughes R, Stapleton P, Watt B, MacKenzie-Shalders K. Signs and symptoms of disordered eating in pregnancy: A delphi consensus study. BMC Pregnancy Childbirth. 2018;18(1):262. doi: 10.1186/s12884-018-1849-3.
• 15. Emery RL, Grace JL, Kolko RP, Levine MD. Adapting the eating disorder examination for use during pregnancy: Preliminary results from a community sample of women with overweight and obesity. Int J Eat Disord. 2017;50(5):597-601. doi: 10.1002/eat.22646.
• 16. Nunes MA, Pinheiro AP, Hoffmann JF, Schmidt MI. Eating disorders symptoms in pregnancy and postpartum: A prospective study in a disadvantaged population in Brazil. Int J Eat Disorder. 2014;47(4):426-430. doi: 10.1002/eat.22236.
• 17. Makino M, Yasushi M, Tsutsui S. The risk of eating disorder relapse during pregnancy and after delivery and postpartum depression among women recovered from eating disorders. BMC Pregnancy Childbirth. 2020;20(1):323.
• 18. Sebastiani G, Andreu-Fernandez V, Herranz Barbero A, et al. Eating disorders during gestation: Implications for mother's health, fetal outcomes, and epigenetic changes. Front Pediatr. 2020;8:587. doi: 10.3389/fped.2020.00587.
• 19. Chua YW, Lewis G, Easter A, Lewis G, Solmi F. Eighteen-year trajectories of depressive symptoms in mothers with a lifetime eating disorder: Findings from the ALSPAC cohort. Br J Psychiatry. 2020;216(2):90-96. doi: 10.1192/bjp.2019.89.
• 20. Balasundaram P, Santhanam P. Eating Disorders. StatPearls. 2023.
• 21. Al Nasser Y, Muco E, Alsaad AJ. Pica. StatPearls. 2023.
• 22. Fawcett EJ, Fawcett JM, Mazmanian D. A meta-analysis of the worldwide prevalence of pica during pregnancy and the postpartum period. Int J Gynaecol Obstet. 2016;133(3):277-83. doi: 10.1016/j.ijgo.2015.10.012.
• 23. Macheka LR, Olowoyo JO, Matsela L, Khine AA. Prevalence of geophagia and its contributing factors among pregnant women at Dr. George Mukhari Academic Hospital, Pretoria. Afr Health Sci. 2016;16(4):972-978. doi: 10.4314/ahs.v16i4.13.
• 24. Kortei NK, Koryo-Dabrah A, Akonor PT, et al. Potential health risk assessment of toxic metals contamination in clay eaten as pica (geophagia) among pregnant women of Ho in the Volta Region of Ghana. BMC Pregnancy Childbirth. 2020;20(1):160.
• 25. Konlan KD, Abdulai JA, Konlan KD, Amoah RM, Doat AR. Practices of pica among pregnant women in a tertiary healthcare facility in Ghana. Nurs Open. May 2020;7(3):783-792. doi: 10.1002/nop2.451.
• 26. Martinez-Olcina M, Rubio-Arias JA, Reche-Garcia C, et al. Eating disorders in pregnant and breastfeeding women: A systematic review. Medicina (Kaunas). 2020;56(7).
• 27. Charbonneau KD, Seabrook JA. Adverse birth outcomes associated with types of eating disorders: A review. Can J Diet Pract Res. 2019;80(3):131-136.
• 28. Mantel A, Hirschberg AL, Stephansson O. Association of maternal eating disorders with pregnancy and neonatal outcomes. JAMA Psychiatry. 2020;77(3):285-293.
• 29. Zanardo V, Cavaliere A, Giliberti E, et al. Gestational weight gain and eating-related disorders. J Obstet Gynaecol. 2021;41(8):1205-1209.
• 30. Santangeli L, Sattar N, Huda SS. Impact of maternal obesity on perinatal and childhood outcomes. Best Pract Res Clin Obstet Gynaecol. 2015;29(3):438-48.
• 31. Catalano PM, Shankar K. Obesity and pregnancy: Mechanisms of short term and long term adverse consequences for mother and child. BMJ. 2017;356:j1.
• 32. Ukah UV, Bayrampour H, Sabr Y, et al. Association between gestational weight gain and severe adverse birth outcomes in Washington State, US: A population-based retrospective cohort study, 2004-2013. Plos Med. 2019;16(12). doi: 10.1371/journal.pmed.1003009.
• 33. Institute of Medicine; National Research Council. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: National Academies Press; 2009.
• 34. Koubaa S, Hallstrom T, Brismar K, Hellstrom PM, Hirschberg AL. Biomarkers of nutrition and stress in pregnant women with a history of eating disorders in relation to head circumference and neurocognitive function of the offspring. BMC Pregnancy Childbirth. 2015;15:318. doi: 10.1186/s12884-015-0741-7.
• 35. Huhmann K. Menses requires energy: A review of how disordered eating, excessive exercise, and high stress lead to menstrual ırregularities. Clin Ther. 2020;42(3):401-407.
• 36. Boutari C, Pappas PD, Mintziori G, et al. The effect of underweight on female and male reproduction. Metabolism. 2020;107:154229. doi: 10.1016/j.metabol.2020.154229.
• 37. Tabler J, Utz RL, Smith KR, Hanson HA, Geist C. Variation in reproductive outcomes of women with histories of bulimia nervosa, anorexia nervosa, or eating disorder not otherwise specified relative to the general population and closest-aged sisters. Int J Eat Disord. 2018;51(2):102-111. doi: 10.1002/eat.22827.
• 38. Galiger-Dobos K, Tury F. Eating disorders and fertility. Psychiatr Hung. 2018;33(4):331-9.
• 39. Kimmel MC, Ferguson EH, Zerwas S, Bulik CM, Meltzer-Brody S. Obstetric and gynecologic problems associated with eating disorders. Int J Eat Disord. 2016;49(3):260-75. doi: 10.1002/eat.22483.
• 40. Ward VB. Eating disorders in pregnancy. BMJ. 2008;336(7635):93-6.
• 41. Micali N, Larsen PS, Strandberg-Larsen K, Andersen AMN. Size at birth and preterm birth in women with lifetime eating disorders: A prospective population-based study. Bjog-Int J Obstet Gy. 2016;123(8):1301-1310. doi: 10.1111/1471-0528.13825.
• 42. Englund-Ogge L, Brantsaeter AL, Juodakis J, et al. Associations between maternal dietary patterns and infant birth weight, small and large for gestational age in the Norwegian Mother and Child Cohort Study. Eur J Clin Nutr. 2019;73(9):1270-1282.
• 43. Deoni S, Dean D, Joelson S, O'Regan J, Schneider N. Early nutrition influences developmental myelination and cognition in infants and young children. Neuroimage. 2018;178:649-659. doi: 10.1016/j.neuroimage.2017.12.056.
• 44. Sadeh-Sharvit S, Levy-Shiff R, Lock JD. Maternal eating disorder history and toddlers' neurodevelopmental outcomes: A brief report. Eat Disord. 2016;24(2):198-205.
• 45. Barona M, Taborelli E, Corfield F, et al. Neurobehavioural and cognitive development in infants born to mothers with eating disorders. J Child Psychol Psychiatry. 2017;58(8):931-398. doi: 10.1111/jcpp.12736.
• 46. Moody L, Chen H, Pan YX. Early-life nutritional programming of cognition-the fundamental role of epigenetic mechanisms in mediating the relation between early-life environment and learning and memory process. Adv Nutr. 2017;8(2):337-350.
• 47. Martini MG, Barona-Martinez M, Micali N. Eating disorders mothers and their children: A systematic review of the literature. Arch Womens Ment Hlth. 2020;23(4):449-467.
• 48. Bould H, Sovio U, Koupil I, et al. Do eating disorders in parents predict eating disorders in children? Evidence from a Swedish cohort. Acta Psychiat Scand. 2015;132(1):51-59.
• 49. Micali N, De Stavola B, Ploubidis G, Simonoff E, Treasure J, Field AE. Adolescent eating disorder behaviours and cognitions: Gender-specific effects of child, maternal and family risk factors. Br J Psychiatry. 2015;207(4):320-7. doi: 10.1192/bjp.bp.114.152371.
• 50. Lydecker JA, Grilo CM. Children of parents with BED have more eating behavior disturbance than children of parents with obesity or healthy weight. Int J Eat Disord. 2017;50(6):648-656. doi: 10.1002/eat.22648.
• 51. Paslakis G, de Zwaan M. Clinical management of females seeking fertility treatment and of pregnant females with eating disorders. Eur Eat Disord Rev. 2019;27(3):215-223.