Neuropsychiatric Disorders among Children of Mothers with EDs

Are children of mothers with eating disorders at greater-than-normal risk of neuropsychiatric diseases? According to the results of a study of Swedish mothers, the answer is Yes.

Angla Mantel, MD, PhD, and her colleagues used the Swedish Medical Birth Registry to study singleton births recorded between January 1, 1990 and December 31, 2012 (JAMA Netw Open. 2022. 5:e2143947). The final population-based study group included 52,878 children, 8813 born to women with eating disorders, and 44,065 matched children born to women without an eating disorder. In addition, to adjusting for shared familial factors, a cluster of exposed children with full maternal cousin comparators was identified.

The authors studied records from 1 year of age on for autism spectrum disorder (ASD) and from 3 years of age on for attention-deficit/hyperactivity disorder (ADHD). The relative risks of ASD and ADHD were assessed among exposed children, then stratified by subtype of ED and ongoing versus previous disease. ASD was defined as at least two registered diagnoses in the patient register during the follow-up period, and ADHD was defined as at least two registered diagnoses in the patient register during the follow-up period and/or dispensed prescription of ADHD-specific drugs in the Prescribed Drug Register. Follow-up started at the index age and ended at the point of outcome, for example, December 31, 2017, or death, or upon migration from Sweden.

The authors found roughly 1.5- to 2-fold increased risks in the children that could not be entirely explained by parental comorbidities or familial confounding. The risk of neuropsychiatric diseases was greatest (roughly two- to fourfold) among children whose mothers had ongoing eating disorders during pregnancy. The results underscore the importance of clinical awareness and increased support for women with eating disorders and their children, as well as the need for future research in this area.