Experiences From Pregnancy and Post-partum Period in Women With a History of Eating Disorders.

Study Overview
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Brief Summary
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Women with the eating disorder bulimia nervosa (BN) have been found to have a higher risk of unplanned pregnancies than healthy women, and experience greater miscarriage, premature birth, birth complications, and postpartum depression. Other studies have found that women with eating disorders seem to find motivation to refrain from the eating disordered behavior for the sake of the fetus, but that it is highly different whether this gives sustained or only a temporary remission. Eating disorders are rarely detected in the primary health care service, nor during pregnancy or during follow-up in fertility clinics. Meeting a health care provider in the pregnancy care service who does not know about the eating disorder or who does not understand the disease well enough, can also make the management and experience of pregnancy and weight gain extra difficult. The aim of this study is to increase the knowledge on how women with a history of eating disorder experience their bodily changes, and how they experience the health service in pregnancy care and post-partum period.

Detailed Description
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Women with the eating disorder bulimia nervosa (BN) have been found to have a higher risk of unplanned pregnancies than healthy women, and experience greater miscarriage, premature birth, birth complications, and postpartum depression. Having a disorder in which the overevaluation of the need to control body weight and food intake is pertinent, may cause a tremendous mental challenge to accept the bodily change through a pregnancy. Other studies have found that women with eating disorders seem to find motivation to refrain from the eating disordered behavior for the sake of the fetus, but that it is highly different whether this gives sustained or only a temporary remission. Eating disorders are rarely detected in the primary health care service, nor during pregnancy or during follow-up in fertility clinics. Meeting a health care provider in the pregnancy care service who does not know about the eating disorder or who does not understand the disease well enough, can also make the management and experience of pregnancy and weight gain extra difficult. The aim of this study is to increase the knowledge on how women with a hisory of eating disorders experience bodily changes through pregnancy, and how the pregnancy care service is experienced. The purpose of this data collection is to help design preparatory information for women with eating disorders who become pregnant, and to promote best practice guidelines for the health service in the meeting with, and follow-up of, pregnant women with a history of eating disorders.

Official Title
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Experiences From Pregnancy and Post-partum Period, and Health Outcomes for Mother and Child, in Women With a History of Eating Disorders.

Conditions
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Pregnancy Related, Eating Disorders, Bulimia Nervosa, Binge-Eating Disorder, Post Partum Depression

Intervention / Treatment
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* Other: Pregnancy
* Other: Post-Partum


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: previous participant in the PED-t project previous/current diagnosis of bulimia nervosa or binge eating disorder has accepted to take part in the long-term follow up study in the PED-t project has been/are pregnant Exclusion Criteria: not matching the above criteria

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 50 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Women from the PED-t study<br>Women who participated in the PED-t study in 2016-2018 who report previous (or in future time) pregnancy. | Other: Pregnancy<br>* Experiences from being pregnant when having a history of eating disorder<br>Other: Post-Partum<br>* Experiences from the post-partum period when having a history of eating disorder<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Experiences of bodily changes in pregnancy and post-partum period | What are the experiences of bodily changes in pregnancy and post-partum period in women with a history of eating disorders? (semistructured interviews) | January 2021 - December 2026 | 
| Experiences with pregnancy health care- and post-partum service | What are the experiences of pregnancy health care service in women with a history of eating disorders? (semistructured interviews) | January 2021 - December 2026 | 
| Quality of prenatal care | Questionnaire rating (Likert scale 0, don't agree - 5, totaly agree) different aspects in the prenatal care service | January 2021 - December 2026 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Current symptoms of eating disorders | Measuring current symptoms of eating disorders at time of interview. Using the eating disorder examination questionnaire by Fairburn. | January 2021 - December 2026 | 
| Current symptoms of depression | Measuring current symptoms of depression at time of interview. Using the Beck Depression inventory. | January 2021 - December 2026 | 
| Planning of pregnancy | Number of pregnancy that was (un)planned, and whether the female was using hormonal contraceptives at time of conception. | January 2021 - December 2026 | 
| Help in becoming pregnant | Number of women in need of fertility assistance/treatment | January 2021 - December 2026 | 
| Supplementation and drugs during pregnancy | Number of women who regularly consumed tobacco/were smoking, drank alcohol, or used prescribed drugs during pregnancy | January 2021 - December 2026 | 
| Body weight during pregnancy | Change in body weight during pregnancy | January 2021 - December 2026 | 
| Blood pressure in pregnancy | Change in blood pressure during pregnancy | January 2021 - December 2026 | 
| Fetus heart rate | Change in fetus heart rate during pregnancy | January 2021 - December 2026 | 
| Symphysis measure | Change in symphysis measure during pregnancy | January 2021 - December 2026 | 
| Frequency and type of pregnancy complication | Numbers experiences different pregnancy complications (chosing from a list of alternatives: abortion, bleedings, edema, gestational diabetes, preeclampsia, pelvic pain) | January 2021 - December 2026 | 
| Birth delivery method | Frequency of different birth delivery methods | January 2021 - December 2026 |