Transtorno alimentar e gravidez de risco: um diagnóstico situacional

Abstract

Objetive: To describe a situational diagnosis of eating disorders in high-risk pregnant women who received prenatal care at a public maternity teaching hospital in Rio de Janeiro, Brazil, during the COVID-19 pandemic. Methods: Adult pregnant women (n = 67) who had type 1 or type 2 diabetes mellitus and/or gestational diabetes mellitus and/or hypertensive syndromes and/or obesity and/or pregestational low weight, and/or a history of bariatric surgery were evaluated using the Eating Disorder Examination Questionnaire (EDE-Q) and a mixed questionnaire to collect sociodemographic, gestational, psychosocial, and nutritional data. A descriptive statistical analysis of the data was performed to calculate the means, frequencies, and standard deviations of the EDE-Q scores and other variables. Results: The participants were on average 31.4 years old (SD = 6.1), in the 28th week of gestation (SD = 6.84), with a pregestational BMI of 29.7 kg/m² (SD = 5.24). The mean EDE-Q score was 4.5 points, indicating potential risk for eating disorders. As for the comorbidities that qualified gestational risk, the most frequent were obesity (52.2%), gestational diabetes mellitus (31.3%), and hypertension (31.3%). Among the women whose global EDE-Q score ≥ 4, 64% were obese, 32% were diagnosed with gestational diabetes mellitus, and 24% had anemia. The frequency of excessive weight concern and shape concern was 13.5% and 14.9%, respectively, while the frequency of binge eating was 22.4%. However, none of the participants reported purgative behaviors for weight control. Conclusions: Even though most of women did not show inappropriate eating behaviors, the global EDE-Q score was high enough to sound a warning as to the need for a service based on nutritional counseling and the deconstruction of dietary myths and beliefs, as well as interventions on the body image of high-risk pregnant women based on appropriate information on gestational weight gain.