Bulimia
Childhood sexual abuse linked to eating disorders during pregnancy
By British Journal of Psychiatry
Sep 2, 2005, 02:21

Pregnant women with a history of eating disorder symptoms are more likely to have a history of unwanted sexual experiences, according to a study published in the September issue of the British Journal of Psychiatry.

Women with marked concern during pregnancy about their weight or shape, or who report using laxatives or self-induced vomiting to control their weight, are also more likely to have a history of sexual abuse.

Although some research indicates that childhood sexual abuse may lead to eating disorders, this evidence does not come from large-scale population studies. This study was designed to explore which early experiences, recalled during pregnancy, were associated with both lifetime, and antenatal, eating disorder symptoms in a community sample.

The Avon Longitudinal Study of Parents and Children, also known as 'Children of the Nineties' project, recruited all women living in the three health districts in Avon who had an expected delivery date between 1st April 1991 and 31st December 1992. Information was collected at recruitment from 14,069 women, but only those who responded to all prenatal questionnaires were included in this study.

The women completed three postal questionnaires: Having a Baby, sent at 18 weeks' into pregnancy; Your Pregnancy, sent at 32 weeks; and About Yourself, which could be completed at any time during the pregnancy.

Your Pregnancy included one question about childhood sexual abuse, and a detailed section of questions about sexual experiences before the age of 16. The same questionnaire also included questions covering eating and weight concerns in the previous 28 days, and before pregnancy.

It was found that mental health problems of the women's own parents, physical and emotional cruelty, sexual abuse and recall of an unhappy childhood all predicted lifetime eating problems, laxative use and vomiting during pregnancy, as well as marked concern during pregnancy over body shape and weight.

Early sexual abuse was a significant independent predictor of lifetime eating disorder and concern about shape and weight. It was noteworthy that a low level of social support was also a significant predictor of weight and shape concerns during pregnancy.

The researchers comment that the multifactorial influences on the development of eating disorder symptoms are substantiated by this large-scale community study.

There are public health implications for these results. Maternal eating problems in the postnatal period have been shown to pose a particular risk to the developing child by interfering with parenting and child growth. Women with excessive concerns about shape and weight are less likely to plan breast-feeding.

Health professionals dealing with pregnant women need to be aware of the prevalence of eating disorder symptoms and the possible association - in some women - with a history of adverse experiences in childhood.

Further research is needed to explore these associations. Interventions designed to improve the outcome for mothers and their children by addressing women's eating disorder symptoms will need to be tested.

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