Perinatal risk factors and disordered eating in children and adolescents.

OBJECTIVE

Studies have reported associations between perinatal factors (obstetric and neonatal factors) and later eating disorder risk. However, previous findings have been partly conflicting. Here, we analyzed associations between perinatal factors and disordered eating in a large cohort of Finnish children and adolescents.

METHOD

The participants were 8- to 14-year-old children and adolescents (N = 11,357) from The Finnish Health in Teens study. Disordered eating was assessed using the Children's Eating Attitudes Test (ChEAT). Perinatal data were obtained from the Finnish Birth Registry. Perinatal variables were initially analyzed using Chi-square analyses and linear regressions. Variables associated with disordered eating (p < .10) were entered into a multinomial logistic regression model. The regression analysis was conducted both including and excluding maternal BMI, as this information was missing for > 80% of the participants.

RESULTS

Of the participants, 56.6% reported disordered eating (ChEAT score ≥ 11) or partial disordered eating (1-10) symptoms. Including maternal BMI in the analyses (n = 1921), higher levels of disordered eating were independently associated with maternal pre-pregnancy BMI (OR 1.07, 95% CI [1.02, 1.12]), maternal smoking during pregnancy (OR 2.64, 95% CI [1.49, 4.68]), urgent or emergency cesarean birth (OR 2.16, 95% CI [1.10, 4.05]). Assisted reproduction was associated with lower levels of disordered eating (OR 0.39, 95% CI [0.20, 0.76]).

DISCUSSION

The results suggest that pregnancy and childbirth are vulnerable developmental periods, associated with later eating pathology. Further studies disentangling genetic and environmental mechanisms of associations between perinatal factors and later eating pathology are needed.

LEVEL OF EVIDENCE

Level III, Evidence obtained from well-designed cohort or case-control analytic studies.