The role of maternal anorexia nervosa and bulimia nervosa before and during pregnancy in early childhood wheezing: Findings from the NINFEA birth cohort study
Corresponding Author
Maja Popovic MD, MSc
Department of Medical Sciences, University of Turin, Turin, Italy
CPO Piemonte, Turin, Italy
Correspondence Maja Popovic, Department of Medical Sciences, University of Turin, Turin, Italy. Email: [email protected]Search for more papers by this authorCostanza Pizzi PhD
Department of Medical Sciences, University of Turin, Turin, Italy
CPO Piemonte, Turin, Italy
Search for more papers by this authorFranca Rusconi MD
Unit of Epidemiology, ‘Anna Meyer’ Children's University Hospital, Florence, Italy
Search for more papers by this authorLuigi Gagliardi MD
Department of Woman and Child Health, Pediatrics and Neonatology Division, Ospedale Versilia, AUSL Toscana Nord Ovest, Pisa, Italy
Search for more papers by this authorClaudia Galassi MD
CPO Piemonte, Turin, Italy
AOU Città della Salute e della Scienza, Turin, Italy
Search for more papers by this authorMorena Trevisan BSc
CPO Piemonte, Turin, Italy
AOU Città della Salute e della Scienza, Turin, Italy
Search for more papers by this authorFranco Merletti MD
Department of Medical Sciences, University of Turin, Turin, Italy
CPO Piemonte, Turin, Italy
AOU Città della Salute e della Scienza, Turin, Italy
Search for more papers by this authorLorenzo Richiardi MD, PhD
Department of Medical Sciences, University of Turin, Turin, Italy
CPO Piemonte, Turin, Italy
AOU Città della Salute e della Scienza, Turin, Italy
Search for more papers by this authorCorresponding Author
Maja Popovic MD, MSc
Department of Medical Sciences, University of Turin, Turin, Italy
CPO Piemonte, Turin, Italy
Correspondence Maja Popovic, Department of Medical Sciences, University of Turin, Turin, Italy. Email: [email protected]Search for more papers by this authorCostanza Pizzi PhD
Department of Medical Sciences, University of Turin, Turin, Italy
CPO Piemonte, Turin, Italy
Search for more papers by this authorFranca Rusconi MD
Unit of Epidemiology, ‘Anna Meyer’ Children's University Hospital, Florence, Italy
Search for more papers by this authorLuigi Gagliardi MD
Department of Woman and Child Health, Pediatrics and Neonatology Division, Ospedale Versilia, AUSL Toscana Nord Ovest, Pisa, Italy
Search for more papers by this authorClaudia Galassi MD
CPO Piemonte, Turin, Italy
AOU Città della Salute e della Scienza, Turin, Italy
Search for more papers by this authorMorena Trevisan BSc
CPO Piemonte, Turin, Italy
AOU Città della Salute e della Scienza, Turin, Italy
Search for more papers by this authorFranco Merletti MD
Department of Medical Sciences, University of Turin, Turin, Italy
CPO Piemonte, Turin, Italy
AOU Città della Salute e della Scienza, Turin, Italy
Search for more papers by this authorLorenzo Richiardi MD, PhD
Department of Medical Sciences, University of Turin, Turin, Italy
CPO Piemonte, Turin, Italy
AOU Città della Salute e della Scienza, Turin, Italy
Search for more papers by this authorFunding information: Compagnia San Paolo Foundation; European Commission (Erasmus Mundus for Western Balkans II programme); Grant Number: E2.D2.14.270
Abstract
Objective
This study evaluates associations of maternal eating disorders (bulimia nervosa, anorexia nervosa, and purging behaviors) with infant wheezing and examines the effects of eating disorders on several wheezing determinants.
Method
We studied 5,150 singletons from the NINFEA birth cohort. Maternal bulimia nervosa and anorexia nervosa diagnoses were ascertained from the questionnaires completed in pregnancy and 6 months after delivery, and were analyzed as: ever diagnosis, only before pregnancy, and during pregnancy. Purging behaviors were assessed for 12 months before or during pregnancy. The associations with wheezing between 6 and 18 months of age were assessed in models adjusted for a priori selected confounders.
Results
Children born to mothers with lifetime eating disorders were at an increased risk of developing wheezing (adjusted OR 1.68; [95% CI: 1.08, 2.60]), and this risk further increased when the disorders were active during pregnancy (2.52 [1.23, 5.19]). Increased risk of offspring wheezing was observed also for purging behaviors without history of eating disorder diagnosis (1.50 [1.10, 2.04]). The observed associations were not explained by comorbid depression and/or anxiety. Bulimia nervosa and/or anorexia nervosa during pregnancy were also associated with several risk factors for wheezing, including maternal smoking, adverse pregnancy outcomes, shorter breastfeeding duration, and day-care attendance.
Discussion
The associations of maternal eating disorders with offspring wheezing suggest long-term adverse respiratory outcomes in children of mothers with eating disorders. A better understanding of mechanisms implicated is necessary to help reduce the respiratory disease burden in these children.
CONFLICT OF INTEREST
The authors declare no conflicts of interest related to this manuscript.
Supporting Information
Additional Supporting Information may be found online in the supporting information tab for this article.
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