Eating Disorders and Pregnancy Outcome in 100,000 Births

饮食失调与 100,000 名新生儿的妊娠结局

基本信息

批准号：
6871661
负责人：
CYNTHIA M BULIK
金额：
$ 48.96万
依托单位：
UNIV OF NORTH CAROLINA CHAPEL HILL
依托单位国家：
美国
项目类别：
财政年份：
2005
资助国家：
美国
起止时间：
2005-02-04 至 2007-12-31
项目状态：
已结题

项目摘要

DESCRIPTION (provided by applicant): Two related and growing bodies of research suggest that women with eating disorders (EDs) experience pregnancy complications more frequently than healthy women, and individuals with EDs are more likely than healthy individuals to have a history of birth complications themselves. More specifically, women with EDs have a higher rate of perinatal complications, cesarean deliveries, and post-partum depression. Moreover, their offspring tend to weigh less than offspring of women without EDs and experience more problems with growth and development. In terms of the second point above, prospective epidemiological research suggests that individuals with anorexia nervosa (AN) are more likely to have been born prematurely, have been small for gestational age (SGA), and have suffered from cephalohematoma. Both bodies of research suggest that perinatal events may be critical to the etiology of EDs and that the perinatal period may be of particular relevance in further elucidating etiological factors in EDs. Although the mechanism of actions is not yet clear, individuals with threshold or subthreshold ED symptoms may increase their risk of adverse pregnancy outcomes by restricting food intake around the time of conception. Indeed, recent animal studies have shown that moderate maternal undernutrition around the time of conception can increase the risk of preterm birth. Together, these studies suggest a cycle of risk, that could be influenced by both genetic and environmental factors, that may flow through generations to perpetuate risk for EDs in families. No study has yet been able to study this cycle of risk in a single population-based sample. We propose to explore the impact of EDs, related behaviors and nutrition during the perinatal period on pregnancy outcome in a sample of 100,000 births in Norway. The Norwegian Mother and Child Cohort Study (Mor & barn undersokelsen) is a prospective population-based study of 100,000 births to 100,000 mothers and 80,000 fathers in Norway. Assessments are extensive including blood for DNA, psychosocial factors, infections, medication use, nutrition, life styles, occupational exposure, use of health services, substance abuse, socioeconomic factors, and chemical and physical factors in the environment. Health variables include fetal ultrasound, maternal and paternal history, and health outcomes for the mother and child detected during and after pregnancy. EDs and related behaviors are assessed at 17 weeks pregnancy and 18 months post partum. This study will provide prospective data on the risk to pregnancy outcome and child development associated with EDs in the mother independent of the effects of depression, anxiety and nutrition.

描述（由申请人提供）：两项相关且不断发展的研究表明，患有饮食失调 (ED) 的女性比健康女性更容易出现妊娠并发症，而且患有 ED 的人比健康人更有可能有出生并发症史。更具体地说，患有 ED 的女性围产期并发症、剖腹产和产后抑郁症的发生率较高。此外，他们的后代往往比没有 ED 的女性后代体重更轻，并且在生长和发育方面遇到更多问题。对于上述第二点，前瞻性流行病学研究表明，神经性厌食症（AN）患者早产、小于胎龄（SGA）和患有头颅血肿的可能性更大。两项研究均表明，围产期事件可能对 ED 的病因学至关重要，并且围产期可能与进一步阐明 ED 的病因因素特别相关。尽管作用机制尚不清楚，但具有阈值或阈下 ED 症状的个体可能会通过在受孕期间限制食物摄入来增加不良妊娠结局的风险。事实上，最近的动物研究表明，怀孕期间母亲适度营养不良会增加早产的风险。总之，这些研究表明，风险循环可能受到遗传和环境因素的影响，可能会代代相传，使家庭中的 ED 风险永久存在。目前还没有研究能够在单一人群样本中研究这种风险周期。我们建议以挪威 100,000 名新生儿为样本，探讨围产期 ED、相关行为和营养对妊娠结局的影响。挪威母婴队列研究 (Mor & barn undersokelsen) 是一项基于人群的前瞻性研究，对挪威 100,000 名母亲和 80,000 名父亲的 100,000 名新生儿进行了研究。评估范围广泛，包括血液 DNA、心理社会因素、感染、药物使用、营养、生活方式、职业暴露、卫生服务的使用、药物滥用、社会经济因素以及环境中的化学和物理因素。健康变量包括胎儿超声检查、母亲和父亲的病史以及怀孕期间和怀孕后检测到的母亲和孩子的健康结果。 ED 和相关行为在怀孕 17 周和产后 18 个月时进行评估。这项研究将提供与母亲 ED 相关的妊娠结局和儿童发育风险的前瞻性数据，与抑郁、焦虑和营养的影响无关。