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Women with eating disorders before childbirth at risk for depressive symptoms

Women who had an eating disorder at any point before childbirth were more likely to experience depressive symptoms during pregnancy and up to 18 years after giving birth, study findings published in British Journal of Psychiatry revealed.

"Depressive symptoms in mothers have been shown to be associated with a number of negative outcomes for their children, such as emotional and behavioral problems,” Francesca Solmi, PhD, from the division of psychiatry, University College London, said in a press release. “It is therefore important, to identify and treat eating disorders early, as these could be one potential cause of the depressive symptoms.”

Researchers examined data from the Avon Longitudinal Study of Parents and Children to determine the long-term trajectories of depressive symptoms from the 18th week of pregnancy to 18 years postnatal in women with self-reported history of anorexia nervosa and/or bulimia nervosa.

They also conducted sensitivity analyses to examine these trajectories using quintiles of measures of body image and eating concerns during pregnancy. Depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS) at 18 and 32 weeks’ gestation; at 8 weeks and 8 months postnatally; and when the children were aged 2, 3, 5, 6, 8, 11 and 18 years.

Of 9,276 women included in the sample, 126 (1.4%) reported a lifetime diagnosis of anorexia nervosa, 153 (1.6%) reported bulimia nervosa and 60 (0.6%) reported both anorexia and bulimia nervosa.

Analysis revealed that women with lifetime eating disorders had greater depressive symptoms scores than those without an eating disorder, even after adjusting for confounders (coefficient = 2.1; 95% CI, 1.36-2.83 for anorexia nervosa; coefficient = 2.28, 95% CI: 1.61-2.94 for bulimia nervosa; coefficient = 2.86; 95% CI, 1.81-3.9 for both anorexia and bulimia nervosa).

Sensitivity analysis also indicated a dose-response relationship between greater body image and eating concerns in pregnancy and more severe trajectories of depressive symptoms. This remained after adjustment for lifetime eating disorders.

"There's a lot of stigma around both depression and eating disorders, so many people might not feel comfortable talking about it or seeking help,” first author Yu Wei Chua, MSc, PhD, from the Laboratory for Innovation in Autism, University of Strathclyde, U.K., said in the release. “Assessment of mental illness in pregnancy, as standard practice, could help health professionals pick up on signs of depression and/or eating disorders at this crucial stage of life." – by Savannah Demko

Disclosure: The authors report no relevant financial disclosures.