Women are more likely to have a child with autism spectrum disorder (ASD) if they have experienced anorexia nervosa before or during pregnancy, according to a new study.
The findings came from studying 52,878 children born in Sweden between 1990 and 2012. A total of 8,800 of these children were born to women who had an eating disorder such as anorexia or bulimia before or during pregnancy.
The study used the Swedish Medical Birth Registry and identified singleton births registered between these years. Children of mothers with eating disorders were matched with comparator children of mothers without eating disorders. To adjust for unmeasured shared familial factors, a cluster of exposed children with full maternal cousin comparators was identified. Follow-up was completed in 2017 and data were analyzed from 2020 to 2021.
Increased likelihood of autism and ADHD
The results of the study, titled Analysis of Neurodevelopmental Disorders in Offspring of Mothers With Eating Disorders in Sweden, showed women who had anorexia during pregnancy were four times as likely to have an autistic child, compared with women who had never had an eating disorder. Furthermore, the chances of having a child with autism were 80% higher among women who had recovered from anorexia prior to pregnancy. An increased likelihood of having a child with ADHD was also identified.
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All children were followed up from one year of age for autism and from three years of age for ADHD. The relative risk of ASD and ADHD was assessed among exposed children, stratified by eating disorder subtype and ongoing vs previous disease, and adjusted for potential confounders, including parental socioeconomic status and comorbidities.
Conclusions and relevance
“Children born to mothers with eating disorders, in particular disorders that were active during pregnancy, were at increased risk of developing ADHD and ASD. The association could not be fully explained by parental psychiatric comorbidities, and among children of mothers with anorexia nervosa and bulimia nervosa, it could not be explained by unmeasured familial confounding,” the researchers commented.
“These findings highlight the importance of clinical awareness and intensified support to women with eating disorders and their children and for future research efforts to identify underlying mechanisms of the association.”
Mantel et al. Analysis of Neurodevelopmental Disorders in Offspring of Mothers With Eating Disorders in Sweden. JAMA Network