Maternal Eating Disorders

: Effects on Pregnancy, Infant and Child Development

Abstract

There is evidence that Eating Disorders (ED) may have implications for fertility, pregnancy and, diet and growth in their children. However, few large longitudinal investigations have been conducted. Women with ED have an increased risk for adverse obstetric outcomes; one proposed pathway is via elevated psychopathology during pregnancy, and consequently foetal overexposure to cortisol and corticotrophin-releasing-hormone, which may in turn have implications for stress regulation in their children. The aim of this thesis was to investigate the effects of ED on fertility and pregnancy, as well as specific aspects of infant and child development. Five interrelated studies were undertaken, utilising two separate methodological approaches. First, a large (n= 12,254) longitudinal birth-cohort was employed to investigate fertility and attitudes towards pregnancy in women with and without ED, and longitudinal patterns of diet and growth in their children. Second, maternal psychopathology and cortisol levels during pregnancy, and potential associations with obstetric outcomes, were investigated in a clinical sample of women with and without ED (n=88). At eight weeks post-natal, infant cortisol levels in response to stress were investigated in a sub-sample of mother-infant dyads (n=59). The findings suggest that women with ED take longer to conceive and more frequently experience negative feelings towards their pregnancy than women without ED. Women with active ED showed persistently high levels of psychopathology and differential diurnal cortisol patterns during pregnancy, which were associated with lower birth weights and shorter gestations. Furthermore, children of women with ED were found to experience elevated cortisol levels, and some differences in dietary patterns and growth trajectories. The general strengths and limitations of these investigations are presented and areas for future research are considered.

Date of Award	1 Sept 2012
Original language	English
Awarding Institution	King's College London
Supervisor	Janet Treasure (Supervisor) & Nadia Micali (Supervisor)