A systematic review of social and interpersonal factors associated with perinatal body image and eating concerns

Disordered eating behaviours and cognitions among pregnant and postpartum women are prevalent public health concerns which can adversely impact mothers, infants and families. While such issues are often linked with the sociocultural environment and interpersonal relationships, these factors are under-researched. The aim of this mixed-methods review was to identify social and interpersonal factors that may protect against or increase the risk of perinatal disordered eating and body image concerns. Following PRISMA reporting guidelines, a systematic search was conducted across MEDLINE, PsycINFO, ProQuest, Scopus, and CINAHL. Two independent reviewers screened articles and extracted data. Results were narratively synthesised. Thirty-six qualitative and quantitative studies were identified. Different sources (partners, friends, healthcare professionals) and dimensions (instrumental, informational, emotional) of social support were protective against symptoms. However, nuances emerged for women with an eating disorder history. Interpersonal abuse, appearance-related commentary and sociocultural pressure were factors associated with increased risk of symptoms. The findings highlight social and interpersonal factors which may perpetuate or mitigate perinatal eating and body image concerns in direct and indirect ways, thus providing insights for clinicians and families. In this way, the onus is shifted away from women, who are already tasked with adapting to the radical changes of entering motherhood, to partners and important others within their sociocultural environment who are well-placed to provide support.