THE ESSENTIAL
- Anorexia nervosa has an increased prevalence in women of childbearing age. Up to one in 200 pregnant women suffer from the disease, according to the study authors.
- 5% of patients with anorexia die from it.
“Many principles developed for the management of anorexia nervosa in adults are applicable during pregnancy, but require modification and adaptation to the physiological, psychological and social changes of pregnancy. Growth and well- being of the fetus must also be taken into consideration”believe scientists from the University of Monash, Australia, who have just published a study on the management of anorexia in pregnant women published in the journal The Lancet Psychiatry.
Risks for the future mother and the baby
Anorexia is an eating disorder characterized by strict and voluntary food deprivation for several months and/or years. Very often, it is associated with psychological problems. In case of pregnancy, anorexia can be very dangerous for the mother-to-be and for the baby. The pregnant woman is at risk of having nutritional and vitamin deficiencies, too low a weight, increased stress, as well as suffering from depression and/or perinatal anxiety. As for the baby, it can also be underweight, born prematurely or stillborn. Although the consequences of this eating disorder are serious, until now doctors had no clear recommendations on how to manage it during pregnancy.
A multidisciplinary approach
Thus, Australian researchers have carried out work to find out what advice to give to health professionals. “The management of anorexia nervosa requires a multidisciplinary team approach with expertise in mental health, specialized medical care, and dietetics. During pregnancy, obstetricians, particularly those managing high-risk pregnancies, physicians and dietitians specializing in pregnancy, pediatricians and mental health clinicians specializing in perinatal care” should all be involved in the management of anorexia, they stress.
The authors believe that the care provided must relate to mental, obstetrical, medical and nutritional health. “Assessment measures used outside of pregnancy, such as body mass index, have been shown to be inconclusive during pregnancy. Clearly, assessment and monitoring measures and tools for anorexia nervosa require modification in the context of pregnancy”, says Megan Galbally, one of the study’s authors. In other words, all health professionals specialized in monitoring pregnant women must be involved.