Chronicity in anorexia nervosa: Pregnancy and birth complications as risk factors

Abstract

The chronic form of anorexia nervosa (AN) affects about one‐quarter of patients and has serious somatic and psychological consequences. This paper presents evidence in support of the hypothesis that pregnancy and birth complications (PBCs) associated with neuropathology may be risk factors for chronic anorexia nervosa. There is increasing evidence that PBCs are risk factors for other psychiatric and somatic disorders. Recent findings of possible premorbid neuropathology in patients with anorexia nervosa suggest that PBCs may be risk factors for chronicity in anorexia nervosa. Topics discussed include the origins of constitutional vulnerability to anorexia nervosa, correlates of PBCs and of chronic anorexia nervosa, the relationship of PBCs to neurological and neurochemical abnormalities, chronicity of anorexia nervosa in relation to PBCs and to neurological and neurochemical abnormalities, and the research implications of the hypothesis that PBCs and associated neuropathology are risk factors for chronicity in anorexia nervosa.

A Retrospective Literature Review of Eating Disorder Research (1990–2021): Application of Bibliometrics and Topical Trends

“…We found a close relationship between AN (T20) and the birth topic (T42), indicating that many researchers examined the effects of birth-related issues on AN. The close relationship between these two topics can be supported by many previous studies examining the relationships between birth patterns and AN [91,92]. Similarly, the abuse topic (T35) was closely related to bulimic symptoms (T6) and BN (T18) and purge behavior (T43).…”

Associations Between Birth Characteristics and Eating Disorders Across the Life Course: Findings From 2 Million Males and Females Born in Sweden, 1975–1998

“…We believe selection bias with respect to explanatory variables is unlikely to explain our results, given that our key findings persist in within-family comparisons. It is, however, unclear whether our findings would generalise to milder community cases, particularly given previous suggestions that birth characteristics may most strongly predict chronic or severe ED 13,26 . Another limitation is that our within-family comparisons could only seek to control for confounding at the mother/family level, and not at the pregnancy or child level.…”

Annotation: Outcome of Anorexia Nervosa in the Younger Patient

“…In a recent study (Steinhausen & Seidel, 1993), the author and his associates failed to replicate earlier findings concerning the negative prognostic impact of premorbid developmental abnormalities on later eating disorders and obesity (Steinhausen & Glanville, 1983b). However, Bakan, Birmingham and Goldner (1991) have argued on both theoretical and empirical grounds that pregnancy and birth complications may be a risk factor {"or chronicity in anorexia nervosa.…”