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Prenatal and perinatal factors and risk of eating disorders

Published online by Cambridge University Press:  08 January 2020

Janne Tidselbak Larsen Open the ORCID record for Janne Tidselbak Larsen [Opens in a new window] ,
Cynthia M. Bulik Open the ORCID record for Cynthia M. Bulik [Opens in a new window] ,
Laura M. Thornton Open the ORCID record for Laura M. Thornton [Opens in a new window] ,
Susanne Vinkel Koch Open the ORCID record for Susanne Vinkel Koch [Opens in a new window]  and
Liselotte Petersen Open the ORCID record for Liselotte Petersen [Opens in a new window]
Janne Tidselbak Larsen*
Affiliation:
National Centre for Register-based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus University, Aarhus, Denmark Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Aarhus, Denmark
Cynthia M. Bulik
Affiliation:
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
Laura M. Thornton
Affiliation:
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
Susanne Vinkel Koch
Affiliation:
Mental Health Centre for Child and Adolescent Psychiatry, Copenhagen Region, Copenhagen, Denmark Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
Liselotte Petersen
Affiliation:
National Centre for Register-based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus University, Aarhus, Denmark Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Aarhus, Denmark
*
Author for correspondence: Janne Tidselbak Larsen, E-mail: jtl@econ.au.dk
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Abstract

Background

Among the most disabling and fatal psychiatric illnesses, eating disorders (EDs) often manifest early in life, which encourages investigations into in utero and perinatal environmental risk factors. The objective of this study was to determine whether complications during pregnancy and birth and perinatal conditions are associated with later eating disorder risk in offspring and whether these associations are unique to EDs.

Methods

All individuals born in Denmark to Danish-born parents 1989–2010 were included in the study and followed from their 6th birthday until the end of 2016. Exposure to factors related to pregnancy, birth, and perinatal conditions was determined using national registers, as were hospital-based diagnoses of anorexia nervosa (AN), bulimia nervosa, and eating disorder not otherwise specified during follow-up. For comparison, diagnoses of depressive, anxiety, and obsessive-compulsive disorders were also included. Cox regression was used to compare hazards of psychiatric disorders in exposed and unexposed individuals.

Results

1 167 043 individuals were included in the analysis. We found that similar to the comparison disorders, prematurity was associated with increased eating disorder risk. Conversely, patterns of increasing risks of EDs, especially in AN, with increasing parental ages differed from the more U-shaped patterns observed for depressive and anxiety disorders.

Conclusions

Our results suggest that pregnancy and early life are vulnerable developmental periods when exposures may influence offspring mental health, including eating disorder risk, later in life. The results suggest that some events pose more global transdiagnostic risk whereas other patterns, such as increasing parental ages, appear more specific to EDs.

Keywords

Anorexia nervosaanxiety disorderbulimia nervosaeating disorder not otherwise specifiedeating disordersepidemiologydepressive disordersobsessive-compulsive disorderperinatal risk factorsprenatal risk factors
Type
Original Article
Information
Psychological Medicine , Volume 51 , Issue 5 , April 2021 , pp. 870 - 880
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Copyright
Copyright © Cambridge University Press 2020

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