Birth complications linked to eating disorders

Children of women who experience birth difficulties seem to be more likely to develop of anorexia and bulimia later in life, Italian researchers suggest.

Previous small studies have implicated complications during pregnancy and childbirth in the risk of anorexia in the offspring, Dr. Paolo Santonastaso and colleagues at the University of Padua note in their report, but only one study considered the role of birth factors in bulimia.

The researchers examined the birthing histories of subjects born at Padua Hospital between 1971 and 1979, including 114 people with anorexia, 73 with bulimia, and 554 comparison subjects.

According to the team’s report in the Archives of General Psychiatry, risk factors for anorexia included anemia and diabetes in the mother, and neonatal heart problems, among others. The presence of two or more of these factors raised the risk of anorexia by nearly sixteen-fold.

Santonastaso’s group theorizes that maternal anemia and diabetes can cause insufficient supply of oxygen and nutrients to the central nervous system of the fetus. Heart problems in a newborn infant can cause low blood flow that results in brain damage.

A finding that the age of onset of anorexia was related to the number of obstetric complications bolsters their theory. Average age of onset was 18.8 years for subjects with no complications, 17.5 for five or fewer complications, and 16.3 for those with more than five complications.

For bulimia, risk factors included low birth weight and early feeding problems, among others. As with anorexia, having two or more of these complications greatly increased the risk of bulimia.

“Future studies,” they conclude, “should try to assess the prognostic impact of the presence of obstetric complications and whether this factor might help in the choice of appropriate and effective treatment.”

SOURCE: Archives of General Psychiatry, January 2006.

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