Effects Of Maternal Eating Disorders Research Articles

Effect of maternal eating disorders on mother-infant quality of interaction, bonding and child temperament: Alongitudinal study.

This study aims to investigate the effect of maternal eating disorders (ED) on mother-infant quality of interaction at 8weeks and bonding and child temperament at 1 and 2years postnatally. We also aimed to explore the relationship between maternal ED psychopathology, comorbid psychiatric difficulties, and both mother-infant quality of interaction and bonding in women with ED. Women were recruited to a prospective longitudinal study. By the time of giving birth, the sample consisted of 101 women of the initial 137 (73.7%). Overall, 62 women (ED=36; HC=26) participated in the 8-week assessment, 42 (ED=20; HC=22) at 1year, and 78 (ED=34; HC=44) at 2years. Mann-Whitney U Test was used to explore association between maternal ED and mother-infant quality of interaction and between maternal ED and bonding. Spearman correlations were used to explore associations between maternal ED psychopathology, comorbid psychiatric difficulties, and both mother-infant quality of interaction and bonding. We found no differences between early mother-infant interaction and bonding in mothers with ED in comparison to HC. High levels of maternal ED psychopathology were correlated with high anxiety levels, higher negative affectivity, and lower extraversion in children of ED mothers both at 1 and 2years. Furthermore, high levels of ED psychopathology were also associated with lower effortful control at 1year. Findings imply that maternal ED have an impact on child temperament. Future research should focus on resilience and on which protective factors might lead to positive outcomes. These factors can be then used as therapeutic and preventative targets.

The effects of maternal eating disorders on child development

The evidence on the effects of maternal eating disorders (ED) on child development is growing and has provided insights on a series of psychopathology, eating and behavioral outcomes (Micali et al., 2014a; 2014b, Easter et al., 2013, 2014). I will firstly present data form my lab highlighting the effects of maternal eating disorders on child psychopathology and development in population-based samples (Micali et al., 2013; Micali et al., 2014). Secondly, I will focus on our work on children of mothers with ED in pregnancy and prior to pregnancy both in clinical samples and in population-based samples. Few studies have focused on the cognitive development of children born to women with ED (active and past). Our group was the first to study cognitive development in infancy and childhood in children born to women with ED as part of a large population-based study of ∼12,000 women (Kothari et al., 2013; 2014, 2015), and a longitudinal clinical sample (Barona et al., 2016). I will then touch upon weight outcomes in children of mothers with active ED behaviors in pregnancy. Altogether these studies highlight an important impact of maternal ED (both active and past) on cognitive and emotional development and weight outcomes. These findings might point to biomarkers of ED or specific effects of pregnancy ED. A summary and conclusion will summarize existing evidence, draw parallels with the literature available in other psychiatric disorders and highlight future research avenues.

Neurobehavioural and cognitive development in infants born to mothers with eating disorders

Although recent research has focused on the effects of maternal eating disorders (EDs) on children, little is known about the effect of maternal EDs on neurobiological outcomes in newborns and infants. This study is the first to investigate neurobehavioural regulation and cognitive development in newborns and infants of mothers with EDs. Women with an active and past ED and healthy controls were recruited to a prospective longitudinal study during their first trimester or second trimester of pregnancy. Newborns and infants of mothers with ED were compared with newborns and infants of healthy controls on (a) neurobehavioural dysregulation using the Brazelton Neonatal Behavioural Assessment Scale at 8days postpartum (active ED, n=15; past ED, n=20; healthy controls, n=28); and (b) cognitive development using the Bayley Scales of Infant and Toddler Development at 1-year postpartum (active ED, n=18; past ED, n=19; healthy controls, n=28). In order to maintain the largest possible sample at each time point, sample size varied across time points. Newborns of mothers with an active ED had worse autonomic stability when compared with newborns of healthy controls [B=-0.34 (-1.81, -0.26)]. Infants of mothers with a past ED had poorer language [B=-0.33 (-13.6, -1.9)] and motor development [B=-0.32 (-18.4, -1.3)] compared with healthy controls. Children of mothers with ED display neurobehavioural dysregulation early after birth and poorer language and motor development at 1year. These characteristics suggest evidence of early neurobiological markers in children at risk. Differential outcomes in children of women with active versus past ED suggest that active symptomatology during pregnancy might have an effect on physiological reactivity while cognitive characteristics might be more stable markers of risk for ED.

Childhood psychopathology in children of women with eating disorders.

We aimed to investigate the effect of maternal eating disorders (ED) on childhood psychopathology, early delays in cognitive, motor and language development, mother and child relationship, and child temperament in a community-based cohort: the Danish National Birth Cohort (DNBC). Data were obtained prospectively on 48 403 children at 18 months and 46 156 children at 7 years. Data on cognitive, motor and language development, temperament and attachment were obtained at 18 months; data on child psychopathology were obtained at 7 years of age, using the Strengths and Difficulties Questionnaire (SDQ). Children of mothers with lifetime diagnosis of anorexia nervosa (AN, n = 931), lifetime diagnosis of bulimia nervosa (BN, n = 906) and both (AN & BN = 360) were compared to children of mothers without an ED (n = 46 206). Girls of women with lifetime AN had higher odds of having emotional problems, and girls of women with lifetime BN of having conduct problems compared with children of healthy women. Boys of women with lifetime AN had higher odds of total, emotional and conduct problems; boys of women with lifetime BN had higher odds of total, conduct, hyperactivity and peer difficulties compared to children of women without an ED. Boys of women with lifetime AN and BN had higher odds of total, emotional and peer problems compared to children of healthy women. Maternal ED is associated with childhood psychopathology in both boys and girls. Boys seemed at higher risk for psychopathology in this sample. Associations between emotional disorders across genders in children of mothers with lifetime AN, and hyperactivity and peer difficulties in boys of mothers with lifetime BN confirm and extend previous findings and point to possible shared risk between ED and other psychopathology.

Engaging Healthcare Providers to Help Mothers with Eating Disorders Create Healthy Eating Environments for Their Children

Eating disorders (EDs), such as anorexia, bulimia, and bingeeating disorder, involve extreme emotions, attitudes, and behaviors surrounding weight, food, and body image, all of which can lead to destructive health consequences. While EDs have innumerable effects on affected individuals, less is known about the consequences for the offspring of childbearing women with past or current EDs. Children of mothers with EDs are at increased risk of various problems during gestation and childhood, including higher rates of miscarriage, cesarean-section deliveries, and stillbirth; greater likelihood of preterm delivery, small- or large-for-gestational-age, low or high birth weight, and growth disturbances; and lower likelihood of being breastfed. These children are also more likely to develop dysfunctional eating habits, behaviors, and attitudes throughout adolescence. Possible effects of maternal EDs on parenting include withholding food from children, using food to reward or punish, a preoccupation with weight interfering with the mother’s responsiveness to her child, failure to express positive attitudes toward eating, and higher tension during mealtimes. These risks are influenced by a variety of factors and the consequences for children are difficult to predict. Complicating matters, the foundations of an ED are established long before diagnosis. The familial setting provides a unique opportunity for integrated and concurrent primary and tertiary ED-prevention strategies for both child and mother. It is imperative for healthcare providers to consider the potential value of educational programs and support for mothers with EDs, as early intervention could interrupt the cycle of risk associated with eating disorders and their effects on the developing child.

Does maternal history of eating disorders predict mothers' feeding practices and preschoolers' emotional eating?

We aimed to examine whether a maternal history of eating disorders predicted mothers' feeding practices and preschoolers' emotional eating patterns. Data were available from 4851 mothers and their children, who participated in a Dutch population-based cohort study (the Generation R Study). Maternal history of lifetime eating disorders was assessed during pregnancy using a self-report questionnaire. Mothers filled out the Child Feeding Questionnaire and the Child Eating Behaviour Questionnaire when children were four years old. Linear regression analyses were performed, adjusting for potential confounders. Of all mothers, 8.6% had a history of an eating disorder (2.5% anorexia nervosa (AN); 3.9% bulimia nervosa (BN); 2.2% both AN and BN). Compared to mothers without a history of eating disorders, mothers with a history of eating disorders, in particular AN, used less pressuring feeding strategies (standardized B = −0.30; 95% CI: −0.49, −0.11). Children of mothers with a history of AN had relatively high levels of emotional overeating (standardized B = 0.19; 95% CI: 0.00, 0.39). Maternal history of BN was not related to mothers' feeding practices or children's emotional eating. Overall, the levels of emotional overeating among children of mothers with a history of eating disorders are noteworthy, particularly considering the young age (4 years) of participating children. This finding may reflect an effect of maternal eating disorders on the development of disordered eating patterns, but could also be subject to mothers' perception.

The effects of maternal eating disorders on offspring childhood and early adolescent psychiatric disorders

There is evidence that parental psychiatric disorders are associated with offspring psychiatric disorder. Very few small studies have investigated the effect of maternal eating disorders on offspring psychopathology throughout childhood and early adolescence. We aimed to investigate psychiatric disorders at age 7, 10, and 13 years in offspring of women with eating disorders prior to pregnancy and investigate the relative contribution of other psychiatric disorders. Women (N = 12,035) from a large population-based longitudinal cohort: the Avon Longitudinal Study of Parents and Children (ALSPAC). A brief prepregnancy psychiatric history was obtained at enrollment to determine exposure. Offspring psychiatric disorder was measured using the developmental and well-being assessment at ages 7, 10, and 13. Maternal eating disorders were associated with a psychiatric diagnosis in the offspring at age 7 and 10, particularly emotional disorders (Odds ratio = 1.9, 95%CI: 1.1-2.8). Maternal psychiatric disorders other than eating disorders predicted psychiatric diagnoses across ages, and acted in an additive fashion with maternal eating disorders. Maternal eating disorders together with comorbid psychopathology increase risk for psychiatric disorders in childhood and early adolescence, in particular for emotional disorders. This has important implications for prevention and future research.

Maternal eating disorders and infant feeding difficulties: maternal and child mediators in a longitudinal general population study

Maternal eating disorders (ED) have been shown to increase the risk of feeding difficulties in the offspring. Very few studies, however, have investigated whether the effect of a maternal ED on childhood feeding is a direct effect or whether it can be ascribed to other child or maternal factors. We aimed to determine the role of maternal anxiety and depression in mediating the risk for feeding difficulties in infants of women with ED. A prospective study comparing women with lifetime ED (441) and without any lifetime psychiatric disorder (10,461) and their infants from the Avon Longitudinal Study of Parents and Children (ALSPAC). We investigated the effect of: maternal anxiety and depression in late pregnancy (32 weeks) and the post-partum (8 weeks), child temperament and developmental status on infant feeding difficulties at 1 and 6 months. We also investigated the effect of active pregnancy ED symptoms. We tested 3 models and their fit to the data using structured equation modelling: a direct effect model, a fully mediational model and an integrated (partial meditational) model. The integrated model including a direct effect of maternal lifetime ED on infant feeding and a mediational path via maternal distress (a latent variable combining anxiety and depression) fitted the data best. This also applied to maternal pregnancy ED symptoms. Feeding difficulties in turn increased maternal distress over time. Lifetime ED and active pregnancy ED increase the risk for infant feeding difficulties and do so via maternal distress (i.e., depression and anxiety). This has important implications for prevention and early intervention in relation to infant feeding difficulties, as well as for future research in the field.