title: Patterns of remission, continuation and incidence of broadly defined eating disorders during early pregnancy in the Norwegian Mother and Child Cohort Study (MoBa).
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.
  
  
  METHODS
  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.
authors.affiliation: Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7160, USA. cbulik@med.unc.edu
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Bulik
authors.forename: Ann
authors.initials: A
authors.lastname: Von Holle
authors.forename: Robert
authors.initials: R
authors.lastname: Hamer
authors.forename: Cecilie
authors.initials: C
authors.lastname: Knoph Berg
authors.forename: Leila
authors.initials: L
authors.lastname: Torgersen
authors.forename: Per
authors.initials: P
authors.lastname: Magnus
authors.forename: Camilla
authors.initials: C
authors.lastname: Stoltenberg
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Siega-Riz
authors.forename: Patrick
authors.initials: P
authors.lastname: Sullivan
authors.forename: Ted
authors.initials: T
authors.lastname: Reichborn-Kjennerud
mesh_terms: D000328:Adult; D000856:Anorexia Nervosa / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D052018:Bulimia Nervosa / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D009664:Norway; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D011262:Pregnancy Trimester, Second; D011446:Prospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors