Neurobehavioral Disorders

Maternal BMI and Eating Disorders Impact Offspring’s Psychiatric Health

Lisa Kuhns, PhD
|
Publish Date
Despite their overall effects on offspring risk of psychiatric diagnoses, a maternal underweight BMI and anorexia nervosa (AN) did not have the same results, suggesting a different, underlying association between AN and adverse birth outcomes.

Maternal eating disorders and prepregnancy BMI outside the normal range were associated with an increased risk for psychiatric disorders in offspring, with eating disorders generally showing larger effect sizes, according to study results published in JAMA Network Open.

In the current study, researchers explored how different maternal eating disorders and prepregnancy BMI influence the neurodevelopmental and psychiatric outcomes in offspring, particularly focusing on the distinctions between maternal anorexia nervosa (AN) and general underweight conditions.

They conducted a population-based register cohort study using data from Finnish medical registries, including the Medical Birth Register and Health Care Register, covering live births in Finland from January 1, 2004, to December 31, 2014.

In total, 392,098 mothers with a mean age of 30.15 years were included in the study. Among these, 10.86% were born outside Finland; 1.60% had a history of eating disorders; 5.89% were underweight before pregnancy; and 53.13% were overweight or obese. Among the 649,956 offspring, 16.43% were diagnosed with a neurodevelopmental or psychiatric disorder by age 7–17.

“
The findings of this cohort study suggest that offspring born to mothers with eating disorders before or during pregnancy, or who had prepregnancy underweight, overweight, or obesity, may be at higher risk of neurodevelopmental and psychiatric disorders.

Maternal eating disorders, including AN, BN, and eating disorders not otherwise specified (EDNOS), were linked to higher risks for nearly all psychiatric diagnoses in offspring, except for intellectual disabilities. Adjusted model results showed increased risks for offspring sleep disorders in the following associations:

  • Maternal eating disorders (hazard ratio [HR], 2.36; 95% CI, 1.89-2.95)
  • Anorexia nervosa (HR, 2.12; 95% CI, 1.53-2.92)
  • Bulimia nervosa (HR, 2.35; 95% CI, 1.67-3.32)
  • Eating disorders not otherwise specified (HR, 3.34; 95% CI, 2.39-4.67)

The models also showed significantly increased risk for social functioning and tic disorders across the following associations:

  • Maternal eating disorders (HR, 2.18; 95% CI, 1.87-2.53)
  • Anorexia nervosa (HR, 2.16; 95% CI, 1.75-2.67)
  • Bulimia nervosa (HR, 2.48; 95% CI, 1.99-3.09)
  • Eating disorders not otherwise specified (HR, 2.79; 95% CI, 2.21-3.52).

Combined adverse birth outcomes and maternal eating disorders further increased risks for feeding disturbances in offspring:

  • Maternal eating disorders (HR, 4.53; 95% CI, 2.97-6.89)
  • Anorexia nervosa (HR, 4.30; 95% CI, 2.38-7.78)
  • Bulimia nervosa (HR, 4.46; 95% CI, 2.32-8.58)
  • Eating disorders not otherwise specified (HR, 4.25; 95% CI, 2.03-8.94)

An underweight maternal prepregnancy BMI increased offspring risks for the following:

  • Anxiety (HR, 1.10; 95% CI, 1.04-1.16)
  • Intellectual disabilities (HR, 1.33; 95% CI, 1.16-1.51).
  • Specific developmental disorders (HR, 1.18; 95% CI, 1.12-1.24)
  • Social functioning and tic disorders (HR, 1.18; 95% CI, 1.06-1.31)

Increasing maternal BMI showed even higher risk for intellectual disabilities, with adverse birth outcomes compounding these risks. The associations are as follows: 

  • Overweight (HR, 1.25; 95% CI, 1.17-1.33)
  • Obesity (HR, 1.61; 95% CI, 1.48-1.77)
  • Severe obesity (HR, 2.04; 95% CI, 1.83-2.28)

Study authors concluded, “The findings of this cohort study suggest that offspring born to mothers with eating disorders before or during pregnancy, or who had prepregnancy underweight, overweight, or obesity, may be at higher risk of neurodevelopmental and psychiatric disorders.”

Study limitations include a short follow-up time, and paternal data and genetic information were not available.

This article originally appeared on Psychiatry Advisor

References:

 Nilsson IAK, Ozsvar J, Gissler M, Lavebratt C. Maternal eating disorders, body mass index, and offspring psychiatric diagnoses. JAMA Netw Open. Published online October 1, 2024. doi:10.1001/jamanetworkopen.2024.40517